Chronic Pulmonary Blastomycosis Mimicking Pulmonary Tuberculosis.

We describe a rare case of chronic pulmonary blastomycosis complicated by large pulmonary cavitation in a young service member who was misdiagnosed with active pulmonary tuberculosis. Case Presentation: A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL). The patient was admitted to an outside hospital and he underwent bronchoscopy with transbronchial biopsies and bronchoalveolar lavage of the RUL. Histology and cultures were unremarkable however; Histoplasma serum antigen was positive. The patient was empirically treated for active pulmonary tuberculosis and soon discharged. He returned for medical evaluation 3 mo later with continued hemoptysis. Repeat bronchoscopy with transbronchial biopsies of the RUL cavity grew Blastomyces dermatitidis. The patient's symptoms resolved and chest imaging significantly improved with initiation of itraconazole. Discussion: Chronic pulmonary blastomycosis can present with a constellation of symptoms that may be indistinguishable from chronic pulmonary histoplasmosis, pulmonary tuberculosis, or lung cancer. Knowledge of endemic diseases and a thorough travel history should be an integral part of a military physician's infectious disease evaluation. PMID: 29547956 [PubMed - as supplied by publisher]
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research

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18F ‐FDG PET/CT has a higher sensitivity and diagnostic accuracy for malignant solitary pulmonary nodule. However, it has a high false positive rate and low specificity when diagnosing SPN in tuberculosis endemic areas. AbstractObjectiveTo determine the diagnostic efficacy of18F ‐FDG PET/CT in distinguishing between pulmonary tuberculosis (PTB) and lung cancer in solitary pulmonary nodule (SPN) in a country with a high prevalence of PTB.MethodsPatients with SPN who underwent18F ‐FDG PET/CT imaging were retrospectively included in the study. The final diagnosis was established by histopathology. A linear regression eq...
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
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Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory infections Source Type: research
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Source: Acta Tropica - Category: Infectious Diseases Authors: Tags: Acta Trop Source Type: research
The present study aims to assess the performance of 18F-FDG PET-CT on mediastinal staging of non-small cell lung cancer (NSCLC) in a location with endemic granulomatous infectious disease.
Source: BMC Cancer - Category: Cancer & Oncology Authors: Tags: Research article Source Type: research
Conclusion: From this first Indian series, it is clear that VATS lobectomy is feasible in both benign and malignant cases. It also shows that the fear of adhesions is unwarranted and properly selected benign cases can also undergo VATS lobectomy safely.
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
Conclusion: Even though the size of our study population was small, the positive rate of 7.4% was like or lower than those in other lung cancer screening studies. Early lung cancer was detected using LDCT screening in one participant. Lung-RADS may be applicable to participants in Korea, where pulmonary tuberculosis is endemic. PMID: 29962887 [PubMed - in process]
Source: Korean J Radiol - Category: Radiology Authors: Tags: Korean J Radiol Source Type: research
CONCLUSIONS: The addition of FDG PET/CT scanning to chest CT imaging provides better performance for predicting conversion to thoracotomy during VATS lobectomy in lung cancer patients. Therefore, in lung cancer patients undergoing surgical resection, FDG PET/CT can provide additional reliable information in selecting the appropriate surgical approach for a lobectomy. PMID: 28932548 [PubMed]
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
Conclusions Incidental detection of granulomatous inflammation in patients undergoing lung resection for cancer, even in a TB-endemic country, may not require any intervention. Such findings may be due to either mycobacterial infection in the past or ‘sarcoid reaction’ to cancer. Although all patients should have their resected specimen sent for acid-fast bacilli culture and followed up until the culture results are reported, the initiation of the management of such patients as per existing lung cancer management guidelines does not affect their outcome adversely.
Source: Journal of Clinical Pathology - Category: Pathology Authors: Tags: Open access, Immunology (including allergy), Lung cancer (oncology), Inflammation, Lung cancer (respiratory medicine) Original article Source Type: research
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Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 1.13 Clinical Problems - Other Source Type: research
Authors: Mittal S, Khalid M, Sabir AB, Khalid S Abstract STUDY DESIGN: Retrospective study. PURPOSE: To note the magnetic resonance imaging (MRI) differences between pathologically proven cases of atypical spinal tuberculosis and spinal metastasis in 40 cases. OVERVIEW OF LITERATURE: Spinal tuberculosis, or Pott's spine, constitutes less than 1% of all cases of tuberculosis and can be associated with a neurologic deficit. Breast, prostate and lung cancer are responsible for more than 80% of metastatic bone disease cases, and spine is the most common site of bone metastasis. Thus, early diagnosis and prompt ...
Source: Asian Spine Journal - Category: Orthopaedics Tags: Asian Spine J Source Type: research
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