[A case of coccidioidomycosis that was extirpated under thoracoscopy]

We report a case of coccidioidosis, which occurred in a 49-year-old Japanese man. He came back to Japan in 1994 after living in California in the U.S. for 2 years, and showed a round shadow in the left lower lung field on chest X-ray. A tumor was 1.4 cm in diameter and located in the left S8 showed by chest CT and the bronchography. It was extirpated under thoracoscopy. Histology of the tumor revealed chronic inflammation of the lung tissue, that contained a spherule of a diameter of 20-60 microns and endospores of a length of 2-6 microns. These structures were identified morphologically as coccidioides immitis. Only 3 cases of benign residual coccidioidal lesions have been reported in Japan including this case.