Cargando…

Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe

Tuberculosis and cryptococcosis are infectious diseases that can result in the formation of single or multiple nodules in immunocompetent patients. Exposure to silica is known to raise the risk of infection with Mycobacterium tuberculosis. We report the case of an elderly man with no history of oppo...

Descripción completa

Detalles Bibliográficos
Autores principales: da Silva, Geruza Alves, Brandão, Daniel Ferracioli, Vianna, Elcio Oliveira, de Sá, João Batista Carlos, Baddini-Martinez, José
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Pneumologia e Tisiologia Paulo 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075891/
https://www.ncbi.nlm.nih.gov/pubmed/24310636
http://dx.doi.org/10.1590/S1806-37132013000500013
_version_ 1782323414899359744
author da Silva, Geruza Alves
Brandão, Daniel Ferracioli
Vianna, Elcio Oliveira
de Sá, João Batista Carlos
Baddini-Martinez, José
author_facet da Silva, Geruza Alves
Brandão, Daniel Ferracioli
Vianna, Elcio Oliveira
de Sá, João Batista Carlos
Baddini-Martinez, José
author_sort da Silva, Geruza Alves
collection PubMed
description Tuberculosis and cryptococcosis are infectious diseases that can result in the formation of single or multiple nodules in immunocompetent patients. Exposure to silica is known to raise the risk of infection with Mycobacterium tuberculosis. We report the case of an elderly man with no history of opportunistic infections and no clinical evidence of immunodeficiency but with a six-month history of dry cough and nocturnal wheezing. A chest X-ray revealed a mass measuring 5.0 × 3.5 cm in the right upper lobe. The diagnostic approach of the mass revealed tuberculosis. The histopathological analysis of the surrounding parenchyma reveled silicosis and cryptococcosis. Cryptococcosis was also found in masses identified in the mediastinal lymph nodes. The surgical approach was indicated because of the degree of pleuropulmonary involvement, the inconclusive results obtained with the invasive and noninvasive methods applied, and the possibility of malignancy. This case illustrates the difficulty inherent to the assessment of infectious or inflammatory pulmonary pseudotumors, the differential diagnosis of which occasionally requires a radical surgical approach. Despite the presence of respiratory symptoms for six months, the first chest X-ray was performed only at the end of that period. We discuss the possible pathogenic mechanisms that might have led to the combination of three types of granulomatous lesions in the same lobe, and we emphasize the need for greater awareness of atypical presentations of pulmonary tuberculosis.
format Online
Article
Text
id pubmed-4075891
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Sociedade Brasileira de Pneumologia e Tisiologia Paulo
record_format MEDLINE/PubMed
spelling pubmed-40758912014-07-16 Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe da Silva, Geruza Alves Brandão, Daniel Ferracioli Vianna, Elcio Oliveira de Sá, João Batista Carlos Baddini-Martinez, José J Bras Pneumol Case Report Tuberculosis and cryptococcosis are infectious diseases that can result in the formation of single or multiple nodules in immunocompetent patients. Exposure to silica is known to raise the risk of infection with Mycobacterium tuberculosis. We report the case of an elderly man with no history of opportunistic infections and no clinical evidence of immunodeficiency but with a six-month history of dry cough and nocturnal wheezing. A chest X-ray revealed a mass measuring 5.0 × 3.5 cm in the right upper lobe. The diagnostic approach of the mass revealed tuberculosis. The histopathological analysis of the surrounding parenchyma reveled silicosis and cryptococcosis. Cryptococcosis was also found in masses identified in the mediastinal lymph nodes. The surgical approach was indicated because of the degree of pleuropulmonary involvement, the inconclusive results obtained with the invasive and noninvasive methods applied, and the possibility of malignancy. This case illustrates the difficulty inherent to the assessment of infectious or inflammatory pulmonary pseudotumors, the differential diagnosis of which occasionally requires a radical surgical approach. Despite the presence of respiratory symptoms for six months, the first chest X-ray was performed only at the end of that period. We discuss the possible pathogenic mechanisms that might have led to the combination of three types of granulomatous lesions in the same lobe, and we emphasize the need for greater awareness of atypical presentations of pulmonary tuberculosis. Sociedade Brasileira de Pneumologia e Tisiologia Paulo 2013 /pmc/articles/PMC4075891/ /pubmed/24310636 http://dx.doi.org/10.1590/S1806-37132013000500013 Text en http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
da Silva, Geruza Alves
Brandão, Daniel Ferracioli
Vianna, Elcio Oliveira
de Sá, João Batista Carlos
Baddini-Martinez, José
Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe
title Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe
title_full Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe
title_fullStr Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe
title_full_unstemmed Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe
title_short Cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe
title_sort cryptococcosis, silicosis, and tuberculous pseudotumor in the same pulmonary lobe
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075891/
https://www.ncbi.nlm.nih.gov/pubmed/24310636
http://dx.doi.org/10.1590/S1806-37132013000500013
work_keys_str_mv AT dasilvageruzaalves cryptococcosissilicosisandtuberculouspseudotumorinthesamepulmonarylobe
AT brandaodanielferracioli cryptococcosissilicosisandtuberculouspseudotumorinthesamepulmonarylobe
AT viannaelciooliveira cryptococcosissilicosisandtuberculouspseudotumorinthesamepulmonarylobe
AT desajoaobatistacarlos cryptococcosissilicosisandtuberculouspseudotumorinthesamepulmonarylobe
AT baddinimartinezjose cryptococcosissilicosisandtuberculouspseudotumorinthesamepulmonarylobe