title: Histoplasmosis mimicking primary lung cancer or pulmonary metastases.
abstract: OBJECTIVE
  To describe the main clinical and radiological characteristics of patients with histoplasmosis mimicking lung cancer.
  
  
  METHODS
  This was a retrospective descriptive study based on the analysis of the medical records of the 294 patients diagnosed with histoplasmosis between 1977 and 2011 at the Mycology Laboratory of the Santa Casa Sisters of Mercy Hospital of Porto Alegre in the city of Porto Alegre, Brazil. The diagnosis of histoplasmosis was established by culture, histopathological examination, or immunodiffusion testing (identification of M or H precipitation bands). After identifying the patients with macroscopic lesions, as well as radiological and CT findings consistent with malignancy, we divided the patients into two groups: those with a history of cancer and presenting with lesions mimicking metastases (HC group); and those with no such history but also presenting with lesions mimicking metastases (NHC group).
  
  
  RESULTS
  Of the 294 patients diagnosed with histoplasmosis, 15 had presented with lesions mimicking primary neoplasia or metastases (9 and 6 in the HC and NHC groups, respectively). The age of the patients ranged from 13 to 67 years (median, 44 years). Of the 15 patients, 14 (93%) presented with pulmonary lesions at the time of hospitalization.
  
  
  CONCLUSIONS
  The clinical and radiological syndrome of neoplastic disease is not confined to malignancy, and granulomatous infectious diseases must therefore be considered in the differential diagnosis.
authors.affiliation: Mycology Laboratory, Santa Casa Sisters of Mercy Hospital of Porto Alegre, Porto Alegre, Brazil. alinegdb@ibest.com.br
authors.forename: Aline Gehlen
authors.initials: AG
authors.lastname: Dall Bello
authors.forename: Cecilia Bittencourt
authors.initials: CB
authors.lastname: Severo
authors.forename: Luciana Silva
authors.initials: LS
authors.lastname: Guazzelli
authors.forename: Flavio Mattos
authors.initials: FM
authors.lastname: Oliveira
authors.forename: Bruno
authors.initials: B
authors.lastname: Hochhegger
authors.forename: Luiz Carlos
authors.initials: LC
authors.lastname: Severo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D006660:Histoplasmosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult