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04:44
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Pulmonary histoplasmosis producing a spindle cell "pseudotumor"
Daniel J Gravdahl1, Jennifer S Gardetto, Jessica R Hurley
1Departments of Pathology, St Joseph’s Hospital and Medical Center, Phoenix, AZ, USA.
American Journal of Clinical Pathology
|August 18, 2011
Summary
Pulmonary spindle cell pseudotumors are rare, often mimicking cancer in immunocompromised individuals. This case identifies Histoplasma capsulatum as a novel cause, emphasizing the need for organism stains in diagnosis.
Area of Science:
- Pulmonology
- Infectious Diseases
- Pathology
Background:
- Pulmonary spindle cell proliferations can mimic neoplasms.
- These lesions are rare and often associated with immunosuppression.
- Diagnostic challenges can delay treatment or lead to unnecessary surgery.
Observation:
- A 67-year-old renal transplant recipient on immunosuppressants developed positron emission tomography-positive lung and mediastinal nodules.
- The patient's condition was initially concerning for malignancy.
- Infection with Histoplasma capsulatum was confirmed through various diagnostic methods.
Findings:
- Histoplasma capsulatum was identified as the causative agent of a pulmonary spindle cell pseudotumor.
- This represents a previously unreported cause of such lesions.
- Diagnostic confirmation involved pleural fluid culture, DNA probe, urinary antigen detection, and silver stains.
Implications:
- Highlights Histoplasma capsulatum as a cause of pulmonary spindle cell pseudotumors.
- Underscores the importance of considering infectious etiologies in immunocompromised patients with spindle cell lesions.
- Emphasizes the utility of special stains for identifying organisms in pulmonary pathology.
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