Pulmonary Fungal Infections in a Tertiary Cancer Center: A Morphological Correlation of 160 Cases with CT and PET...

Background: Pulmonary fungal infections can mimic malignancies, especially in patients with a prior cancer diagnosis. This study presents 160 patients who were suspected to have malignancies but were diagnosed with fungal infections. Methods: Clinical, radiological, and histopathological features were recorded for all 160 patients. The patients included 61 women and 99 men, aged between 23 and 78 years (median age: 61 years). Diagnostic imaging identified either single or multiple pulmonary nodules. Tissue diagnosis was obtained in all cases, identifying various etiological agents, with Histoplasma, Cryptococcus, and Aspergillus being the top three infections. Results: Out of the 160 patients, 61 (38.1%) had a prior history of malignancy, and 29 (18.1%) had ongoing evidence of malignancy. Ninety-nine patients had no history of prior malignancy but presented with abnormal diagnostic imaging findings. The presence of single or multiple lesions in the lung, especially in patients with a history of malignancy, posed a diagnostic challenge, often raising the possibility of metastatic disease or primary lung malignancy. Conclusions: Patients with single or multiple pulmonary nodules, particularly those with a history of malignancy, should undergo tissue diagnosis to accurately define the process. This comprehensive assessment is crucial to determine whether the nodules are due to an infectious process or malignancy.