Histoplasmomas of uncommon size

Chest. 2013 Jun;143(6):1795-1798. doi: 10.1378/chest.12-2071.

Abstract

Histoplasma capsulatum infection demonstrates a broad spectrum of acute and chronic clinical manifestations. Unlike the acute reaction to proliferating organisms, the chronic complications are often the result of excessive or prolonged host response with a paucity of organisms. Lung nodules (histoplasmomas) may be noted decades after initial infection and present a challenging clinical problem, as they can be difficult to distinguish from malignancy or tuberculomas. Typically, histoplasmomas are small (<1 cm), asymptomatic, and may be stable in size or slowly enlarge over time. Here we report three patients with unusually large, or giant, histoplasmomas (>3 cm) and describe their extreme phenotype. Importantly, two of the patients presented with subacute symptomatic disease, a presentation that is very atypical for histoplasmoma. The term "buckshot" calcification has been used to describe dozens of small (2-4 mm) calcified nodules, so it may be appropriate to label masses that exceed 3 cm as "cannonball" histoplasmoma.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Child
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Female
  • Histoplasmosis / diagnosis*
  • Histoplasmosis / microbiology*
  • Histoplasmosis / therapy
  • Humans
  • Lung Diseases / diagnosis*
  • Lung Diseases / microbiology*
  • Lung Diseases / therapy
  • Male
  • Middle Aged