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Difficult to Diagnose: An Unusual Cause of Cavitary Lung Lesion

Hallie E. Norman, Jonathan M. Davis, Dipen Kadaria

(College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA)

Am J Case Rep 2020; 21:e921274

DOI: 10.12659/AJCR.921274

BACKGROUND: Cavitary lung lesions are commonly identified on thoracic imaging, but typically require further workup for definitive diagnosis.
CASE REPORT: Here, we present the case of a 40-year-old Middle Eastern male who presented with an unusual cause of cavitary lung lesion with associated pleural mass and pleural thickening. He underwent bronchoscopic biopsy and computer tomography (CT)-guided core needle biopsy, both of which were non-diagnostic. Surgical biopsy subsequently revealed hyalinized necrotizing granulomatous tissue, consistent with histoplasmosis, and the patient was treated with itraconazole, which he responded well to.
CONCLUSIONS: This case demonstrates the importance of identifying unusual causes of cavitary lung lesions and emphasizes the role of using proper tissue sampling for diagnosis.

Keywords: Biopsy, Histoplasmosis, Lung Diseases, Fungal, Multiple Pulmonary Nodules

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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