Primary pulmonary botryomycosis with multiple adjacent organ involvement mimicking mucosa-associated lymphoid tissue lymphoma.
Botryomycosis is an unusual chronic suppurative disease characterized by the histological finding of sulphur granules containing the causative bacteria in an abscess. We describe a previously healthy 14-year-old girl who presented with chronic productive cough. Chest computed tomography (CT) revealed a right lower mass with involvement of the parietal pleura, chest wall, diaphragm, liver and costovertebral junction. Thoracostomy biopsy was performed due to suspicion of low-grade mucosa-associated lymphoid tissue lymphoma. However, histological analysis revealed a pulmonary botryomycosis. The right lower lung mass completely resolved after 3 months of antibiotics treatment. This case emphasizes that primary pulmonary botryomycosis with extensive contiguous involvement may not be distinguishable from lung cancer, lymphoma or fungal infection on chest CT.
Leong
Yew-Loong
YL
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Liaw
Yuang-Shuang
YS
Chang
Yih-Leong
YL
Lee
Yung-Chie
YC
D000293:Adolescent; D020171:Botrytis / Q000302:isolation & purification*; D003937:Diagnosis, Differential; D003964:Diaphragm / Q000382:microbiology; D005260:Female; D006801:Humans; D008099:Liver / Q000382:microbiology; D008172:Lung Diseases, Fungal / Q000175:diagnosis*; D008175:Lung Neoplasms / Q000175:diagnosis*; D018442:Lymphoma, B-Cell, Marginal Zone / Q000175:diagnosis*; D010994:Pleura / Q000382:microbiology; D013904:Thoracic Vertebrae / Q000382:microbiology; D035441:Thoracic Wall / Q000382:microbiology