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Histoplasmosis simulating lymphoma in children.

W G Woods, L J Singher, W Krivit

    Journal of Pediatric Surgery
    |August 1, 1979
    PubMed
    Summary
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    Primary histoplasmosis of the mediastinum, a fungal infection, can mimic lymphoma in children. Histologic confirmation is crucial before initiating treatments like radiation for mediastinal masses.

    Area of Science:

    • Mycology
    • Pediatric Oncology
    • Infectious Diseases

    Background:

    • Histoplasmosis is a fungal infection often affecting the lungs.
    • Mediastinal masses in children can present diagnostic challenges, sometimes mimicking malignancies like lymphoma.

    Observation:

    • A review of two hospitals' experience over 10 years identified 11 pediatric cases of histoplasmosis.
    • Six of these pediatric patients presented with systemic symptoms and a mediastinal mass, but no pulmonary infiltrates.
    • Clinical diagnosis in these six cases was lymphoma.

    Findings:

    • Pathologic diagnosis revealed primary histoplasmosis of the mediastinum in these cases.
    • Immediate radiation therapy was considered for respiratory compromise in one patient before diagnosis.

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  • Histologic confirmation is essential before initiating treatments for acute respiratory compromise caused by mediastinal masses.

    • Implications:

    • Primary histoplasmosis of the mediastinum may be more prevalent than previously recognized.
    • This condition can be misdiagnosed as lymphoma, delaying appropriate antifungal treatment.
    • Emphasizes the importance of histopathological diagnosis to guide therapy for pediatric mediastinal masses.