Medical image of the week: fungus ball

Southwest Journal of Pulmonary and Critical Care

Poojary I¹  Larsen B¹  Barker B¹  Rosen S¹ 

[1] University of Arizona, Tucson, AZ USA;

关键词: fungus ball;    mycetoma;    CT scan;    histology;    Valley fever;    coccidioidomycosis;    treatment;    surgical resection;    surgical pathology;    mycelia;   

DOI  :  10.13175/swjpcc025-15

来源: DOAJ

【 摘 要 】

No abstract available. Article truncated at 150 words. A 69 year-old Asian woman living in Arizona with a past medical history of nephrotic syndrome on high-dose steroids had worsening pulmonary symptoms. A computed tomography (CT) of the chest (Figure 1) showed a 4.7 cm thin walled cavitary lesion in the right middle lobe compatible with mycetoma. She underwent thoracotomy for mycetoma resection. Surgical pathology confirmed an epithelial-lined cavity containing dense mycelia (Figure 2). Given the patient lived in an endemic area; the cavity was thought to be likely due to coccidioidomycosis. However, the mycetoma was of unclear etiology. No spherules were noted on GMS stain and tissue culture was negative. While of unclear clinical significance which fungus colonizes a pre-existing cavity, a Coccidioides PCR was performed and no Coccidioides genes were amplified making a Coccidioides mycetoma very unlikely. Pulmonary mycetoma or “fungus ball” consists of dense fungal elements and amorphous cellular material within a pre-existing pulmonary cavity. Classically ...

【 授权许可】

Unknown