Paracoccidioides brasiliensis Infection Mimicking Recurrent Hodgkin Lymphoma: A Case Report and Review of the Literature

Mycopathologia
Ayaz GhaniSteven Sieber

Abstract

Paracoccidioides infection is a rare entity in the USA. This dimorphic fungus is found in Central and South America and is thought to be acquired by inhalation through the soil. We report a case of Paracoccidioides brasiliensis infection presenting as a clavicular bone lesion, peripancreatic mass, and various skin lesions. A 35-year-old man with a history significant for Hodgkin lymphoma presented with a left clavicular mass that was suspected clinically and radiologically as recurrent Hodgkin lymphoma. He was not experiencing any associated symptoms and was undergoing chemotherapy treatment for his known Hodgkin disease. On CT imaging, the mass was seen as a lytic bone lesion with an overlying soft tissue mass. This was biopsied and histologically diagnosed as a Paracoccidioides brasiliensis infection with associated necrotizing granulomatous inflammation. Also found on the CT scan was an enlarging peripancreatic mass which on endoscopic biopsy had similar histologic findings. In conclusion, this report presents a rare case of Paracoccidioides brasiliensis infection mimicking recurrent Hodgkin lymphoma.

References

Apr 1, 1993·Clinical Microbiology Reviews·E BrummerA Restrepo
Sep 25, 1999·The American Journal of Tropical Medicine and Hygiene·M H BlottaZ P Camargo
May 15, 2001·Epidemiology and Infection·D CalleA Restrepo
Sep 18, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·A M TobónA Restrepo
Aug 3, 2004·Revista Do Instituto De Medicina Tropical De São Paulo·Ricardo Mendes PereiraAntonia Teresinha Tresoldi
Aug 15, 2006·Revista Da Sociedade Brasileira De Medicina Tropical·Maria Aparecida Shikanai-YasudaMaria Luiza Moretti
Mar 28, 2008·Seminars in Respiratory and Critical Care Medicine·Angela RestrepoAngela M Tobón
Apr 3, 2008·Expert Review of Anti-infective Therapy·Luiz R TravassosArnaldo L Colombo
Dec 21, 2014·Mycopathologia·Lucilene Silva Ruiz e ResendeMaria Aparecida Custódio Domingues

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Methods Mentioned

BETA
biopsy
periodic acid Schiff

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