Endobronchial pseudo-tumour caused by herpes simplex

Abstract

Herpes simplex virus (HSV) causes tracheobronchitis and pneumonitis; however, to date, there has only been one report of an endobronchial mass caused by HSV type II.This case study describes a 68-yr-old female with severe kyphoscoliosis who was intubated for acute on chronic hypercapnic respiratory failure and developed blood-tinged endotracheal secretions.Fibreoptic bronchoscopy demonstrated an endobronchial mass in the right middle lobe. Cultures grew HSV type I and biopsy specimens demonstrated cytopathological changes consistent with HSV infection. This is the first reported case of HSV type I presenting as an endobronchial tumour.

Herpes simplex lesion mimicking left upper lobe bronchial tumour

“…Diagnosis is based on nuclear inclusion identified on cytological analysis in samples obtained from bronchoscopic examination and on the detection of HSV by virus culture or, more commonly, quantitatively by nucleic acid amplification techniques 2 3…”

Hypertrophic Herpes Simplex Virus Type 1 Infection in a Patient With Acute Myeloid Leukemia

“…Both patients developed tongue masses due to HSV-1 infection. The third patient with restrictive lung disease without apparent immunocompromise developed endotracheal mass caused by HSV-1 [4]. The last patient with acquired immunodeficiency syndrome developed nodules in the anal area and the immunochemistry revealed HSV-1 infection [5].…”

“…Reactivation of HSV-1 occurs with various trigger factors and usually forms red macules on the mucocutaneous junction of the lips which rapidly become vesicular, then form pustular scabs and ulcers. HSV-1 may form atypical lesions in immunocompromised patients; however, it is extremely rare that it forms mass, tumoral, or hypertrophic lesions as occasionally seen in the anogenital regions of patients infected with human immunodeficiency virus (HIV) due to HSV type 2 (HSV-2) infection [2][3][4][5][6][7].…”

Tumores perianais provocados pelo herpes simples

“…9 Apesar da forma ulcerativa ser a mais conhecida, a literatura relata o aparecimento de lesões tumorais, nodulares ou hipertróficas relacionadas ao vírus. [10][11][12][13][14][15] Esse aspecto vem sendo observado em doentes imunodeprimidos, entre eles transplantados em uso de medicação imunodepressora e portadores do vírus da imunodeficiência adquirida (HIV). 13,[15][16][17] Macroscopicamente, trata-se de tumores dolorosos, achatados, com superfície recoberta por ulceração rasa e com bordas bem delimitadas, elevadas e lobuladas, localizados na margem anal e/ou no sulco interglúteo, 16,17 algumas vezes imitando condilomas virais 15 ou carcinoma.…”

“…13,[15][16][17] Macroscopicamente, trata-se de tumores dolorosos, achatados, com superfície recoberta por ulceração rasa e com bordas bem delimitadas, elevadas e lobuladas, localizados na margem anal e/ou no sulco interglúteo, 16,17 algumas vezes imitando condilomas virais 15 ou carcinoma. 13,16,17 Lesões semelhantes também foram descritas no lóbulo da orelha e ponta dos dedos, 14 na lín-gua, 18 no pênis e na bolsa escrotal, 12 O motivo dessa evolução anômala não está definido, mas provavelmente o mecanismo deve ser imunológico. [15][16][17]19 Entre as hipóteses, há referências sobre a deficiência das células dendríticas plasmocitóides em produzir interferon-alfa, o que ocorre em doentes com AIDS e predispõe à doenças oportunistas.…”