Syphilitic Pulmonary Inflammatory Pseudotumor: A Diagnostic Challenge

Abstract

A 46-year-old man presented with nonproductive cough and lower limb swelling. Chest radiograph showed a left lower lobe lung mass and multiple subpleural nodules. Other investigations revealed that he had nephrotic syndrome. Core biopsies of the left lower lobe lung mass showed features of inflammatory pseudotumor with endarteritis obliterans and a lymphoplasmacytic infiltrate. Immunohistochemical stain for Treponema pallidum was positive. Resolution of the lung mass and nephrotic syndrome was achieved after treatment with intramuscular benzathine benzylpenicillin. The differential diagnosis of pulmonary inflammatory pseudotumor, manifestations of pulmonary syphilis, and a literature review of secondary syphilis of the lung are discussed.

A fatal multiple-lesion, inflammatory, pseudotumor in the lung: a rare case report

“…Generally, PIP may have a number of different causes. It is related to chronic inflammation; acquired immunodeficiency syndrome (AIDS), thymoma surgery, histoplasmosis, syphilis, and interferon treatment ( 5 ). However, it is exceedingly rare to have multiple lesions outside the lung (especially over the body).…”