Mediastinal histoplasmosis: report of the first two Brazilian cases of mediastinal granuloma

• Author(s): Severo, Luiz Carlos ; Lemos, Antonio Carlos Moreira ; Lacerda, Heloisa Ramos
• Date: 2005
• Origin: Oasisbr
• Subject(s): Histoplasmosis; Histoplasma capsulatum var. capsulatum; Mediastinal histoplasmosis; Mediastinal granuloma
• Document Type: Journal article
• Language: English

Description

This report documents the first two Brazilian cases of mediastinal granuloma due to histoplasmosis, presenting selected aspects on the diagnosis. Tissue samples revealing histoplasmosis were obtained from each of the patients by mediastinoscopy and thoracotomy. In the second patient, a subcarinal calcified mass eroded into the bronchial tree, leading to secondary bilateral aspiration pneumonitis one week after thoracotomy. Although rare, histoplasmosis should be included in the differential diagnosis of mediastinal granuloma, specially if there are calcifications greater than 10 mm in dimension.

São relatados os dois primeiros casos de granuloma mediastinal por histoplasmose no Brasil, apresentando aspectos selecionados sobre dignóstico. O diagnóstico tecidual de histoplasmose foi obtido por mediastinoscopia e toracotomia, respectivamente. Em um paciente a massa calcificada subcarinal erodiu na árvore brônquica com pneumonite de aspiração bilateral uma semana após a toracotomia. Embora rara, histoplasmose deve ser incluída no diagnóstico diferencial de granuloma mediastinal especialmente com calcificação maior do que 10 mm de diâmetro.