Mediastinal histoplasmosis: report of the first two Brazilian cases of mediastinal granuloma

Abstract

This report documents the first two Brazilian cases of mediastinal granuloma due to histoplasmosis, presenting selected aspects on the diagnosis. Tissue samples revealing histoplasmosis were obtained from each of the patients by mediastinoscopy and thoracotomy. In the second patient, a subcarinal calcified mass eroded into the bronchial tree, leading to secondary bilateral aspiration pneumonitis one week after thoracotomy. Although rare, histoplasmosis should be included in the differential diagnosis of mediastinal granuloma, specially if there are calcifications greater than 10 mm in dimension.

Histoplasmosis presenting with multiple pulmonary nodules. A case mimicking radiological features of pulmonary metastasis

“…The disease is resolved spontaneously over a period of 2-4 weeks. The roentgenographic signs are resolved completely in 2-4 months or leave calcifield hilar and/or mediastinal lymph nodes or pulmonary histoplasmomas 6,[14][15][16] .…”