Mediastinal histoplasmosis: report of the first two Brazilian cases of mediastinal granuloma Histoplasmose mediastinal: relato dos dois primeiros casos brasileiros de granuloma mediastinal

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Luiz Carlos Severo, Antonio Carlos Moreira Lemos, Heloisa Ramos Lacerda
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2005
• Subjects: Histoplasmosis; Histoplasma capsulatum var. capsulatum; Mediastinal histoplasmosis; Mediastinal granuloma; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/S0036-46652005000200009; https://doaj.org/article/4040f9b04fe447b8abdfae6b7ef63180

This report documents the first two Brazilian cases of mediastinal granuloma due to histoplasmosis, presenting selected aspects on the diagnosis. Tissue samples revealing histoplasmosis were obtained from each of the patients by mediastinoscopy and thoracotomy. In the second patient, a subcarinal calcified mass eroded into the bronchial tree, leading to secondary bilateral aspiration pneumonitis one week after thoracotomy. Although rare, histoplasmosis should be included in the differential diagnosis of mediastinal granuloma, specially if there are calcifications greater than 10 mm in dimension. São relatados os dois primeiros casos de granuloma mediastinal por histoplasmose no Brasil, apresentando aspectos selecionados sobre dignóstico. O diagnóstico tecidual de histoplasmose foi obtido por mediastinoscopia e toracotomia, respectivamente. Em um paciente a massa calcificada subcarinal erodiu na árvore brônquica com pneumonite de aspiração bilateral uma semana após a toracotomia. Embora rara, histoplasmose deve ser incluída no diagnóstico diferencial de granuloma mediastinal especialmente com calcificação maior do que 10 mm de diâmetro.