Histoplasmomas of uncommon size.

Richmond BW, Worrell JA, Bastarache JA, Gervich DH, Slattery WR, Loyd JE
Chest. 2013 143 (6): 1795-1798

PMID: 23732591 · DOI:10.1378/chest.12-2071

Histoplasma capsulatum infection demonstrates a broad spectrum of acute and chronic clinical manifestations. Unlike the acute reaction to proliferating organisms, the chronic complications are often the result of excessive or prolonged host response with a paucity of organisms. Lung nodules (histoplasmomas) may be noted decades after initial infection and present a challenging clinical problem, as they can be difficult to distinguish from malignancy or tuberculomas. Typically, histoplasmomas are small (<1 cm), asymptomatic, and may be stable in size or slowly enlarge over time. Here we report three patients with unusually large, or giant, histoplasmomas (>3 cm) and describe their extreme phenotype. Importantly, two of the patients presented with subacute symptomatic disease, a presentation that is very atypical for histoplasmoma. The term "buckshot" calcification has been used to describe dozens of small (2-4 mm) calcified nodules, so it may be appropriate to label masses that exceed 3 cm as "cannonball" histoplasmoma.

MeSH Terms (10)

Adolescent Child Combined Modality Therapy Diagnosis, Differential Female Histoplasmosis Humans Lung Diseases Male Middle Aged

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