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Published on: March 22, 2012
Adiaspiromycosis mimicking widespread malignancy in a patient with pulmonary adenocarcinoma
J L Denson1, C E Keen, P O Froeschle
1Department of Histopathology, Plymouth Hospitals NHS Trust, Crownhill, Plymouth, Devon, UK. jem_denson@yahoo.co.uk
Abstract:
Adiaspiromycosis, a mycotic disease of small animals, has rarely been reported in humans. The principle causative organism in Europe is Emmonsia crescens. Inhaled, dust-borne spores of E crescens fail to germinate in host tissue, instead increasing in size dramatically to become thick-walled, round adiapsores, which induce a granulomatous response. The pathological effects depend on the spore burden and host immunocompetence, and range from asymptomatic infection through to necrogranulomatous pneumonia, respiratory failure and, rarely, death. Diagnosis is principally made through histological examination. This report describes a case of a patient with low-grade, localised pulmonary adenocarcinoma with occult adiaspiromycosis that radiologically mimicked widespread malignancy. It is believed to be the first reported human case of adiaspiromycosis in the UK.
Insights
Adiaspiromycosis, a rare fungal infection, was found alongside lung cancer in a UK patient. This case highlights the importance of considering fungal infections in respiratory diagnoses.
Area of Science:
- Mycology
- Pulmonology
- Pathology
Background:
- Adiaspiromycosis is a rare fungal infection primarily affecting small animals, caused by Emmonsia crescens spores.
- Human infections are infrequent, with pathological effects varying based on spore load and host immunity.
Observation:
- A case report details a patient with low-grade pulmonary adenocarcinoma.
- The patient presented with radiological findings that mimicked widespread malignancy.
Findings:
- Occult adiaspiromycosis was diagnosed in the patient alongside pulmonary adenocarcinoma.
- Histological examination was crucial for diagnosing the co-existing conditions.
Implications:
- This case represents the first reported human adiaspiromycosis in the UK.
- It underscores the need to consider rare fungal infections in differential diagnoses of pulmonary conditions, especially when radiological findings are atypical.
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