Varicella-zoster Virus Related Pulmonary Granulomas in Which Varicella-zoster Virus DNA Was Demonstrated in a Thoracoscopic Lung Biopsy Specimen

Intern Med. 2019 Jul 15;58(14):2101-2105. doi: 10.2169/internalmedicine.2021-18. Epub 2019 Mar 28.

Abstract

A 43-year-old man with malignant lymphoma who had been treated with the cyclosphamide, vincrstine, procarbazine, and prednisolone (C-MOPP) regimen was admitted to our hospital with skin eruption. He was diagnosed to have varicella, and treatment with acyclovir and immune globulin was started. Chest computed tomography revealed multiple nodules in the both lung fields. Diagnostic thoracoscopic lung biopsy specimens revealed granuloma formation, and polymerase chain reaction testing revealed the presence of varicella-zoster virus DNA in the granulomatous tissue. It was unusual for the lung nodule in varicella pneumonia to increase in size over time in a patient who had undergone antiviral therapy, while also demonstrating multiple granulomas.

Keywords: malignant lymphoma; pulmonary granulomas; varicella pneumonia.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Adult
  • Antiviral Agents / therapeutic use
  • Cyclophosphamide / therapeutic use
  • DNA, Viral / isolation & purification
  • Granuloma / genetics*
  • Granuloma / virology*
  • Humans
  • Male
  • Pneumonia / etiology
  • Pneumonia / pathology*
  • Pneumonia / virology*
  • Polymerase Chain Reaction
  • Prednisolone / therapeutic use
  • Procarbazine / therapeutic use
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Varicella Zoster Virus Infection / complications*
  • Varicella Zoster Virus Infection / diagnosis
  • Varicella Zoster Virus Infection / drug therapy*
  • Varicella Zoster Virus Infection / genetics*
  • Vincristine / therapeutic use

Substances

  • Antiviral Agents
  • DNA, Viral
  • Procarbazine
  • Vincristine
  • Cyclophosphamide
  • Prednisolone
  • Acyclovir