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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Pneumologia e Tisiologia Paulo
2013
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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 |
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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 |
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