Pulmonary Histoplasmosis Mimicking Metastatic Lung Cancer: A Case Report.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_9F9AE8B477BA
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Pulmonary Histoplasmosis Mimicking Metastatic Lung Cancer: A Case Report.
Journal
Diagnostics
Author(s)
Ruegg G., Zimmerli S., Trachsel M., Berezowska S., Engelbrecht S., Martin Y., Perrig M.
ISSN
2075-4418 (Print)
ISSN-L
2075-4418
Publication state
Published
Issued date
17/02/2021
Peer-reviewed
Oui
Volume
11
Number
2
Pages
328
Language
english
Notes
Publication types: Case Reports
Publication Status: epublish
Abstract
Histoplasmosis is a well-known endemic fungal infection but experience in non-endemic regions is often limited, which may lead to delayed diagnosis and extensive testing. The diagnosis can be especially challenging, typically when the disease first presents with pulmonary nodules accompanied by hilar and mediastinal lymphadenopathy, suggesting a much more common malignant disease. In this situation, a greater FDG uptake in draining lymph nodes in comparison with the associated lung nodule seen in [ <sup>18</sup> F]FDG-PET/CT, the so-called "flip-flop fungus" sign, can help to orientate further diagnostic measures. We report a case of a 56-year-old woman living in Switzerland, a non-endemic region, whose diagnosis of imported histoplasmosis was delayed since the findings had been initially misinterpreted as pulmonary malignancy. Further, histological workup was inconclusive due to lack of specific fungal staining, leading to ineffective treatment and non-resolving disease. This paper intends to highlight the pitfalls in diagnosing Histoplasma capsulatum and presents images of particularities of fungal infections in [ <sup>18</sup> F]FDG-PET/CT, which in our case showed a "flip-flop fungus" sign.
Keywords
PET-CT, flip-flop fungus sign, histoplasma capsulatum, lymphadenopathy, necrotic granulomatosis, pulmonary lesion
Pubmed
Web of science
Open Access
Yes
Create date
08/03/2021 7:55
Last modification date
21/11/2022 8:28
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