Pulmonary histoplasmosis producing a spindle cell "pseudotumor"

Daniel J. Gravdahl, Jennifer S. Gardetto, Jessica R. Hurley, Henry D. Tazelaar, Paul W. Koontz, Kevin O. Leslie

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Pulmonary spindle cell proliferations have been reported in association with a limited group of infectious agents. These lesions are rare and identified most often in the setting of immunosuppression. Because their appearance can simulate a spindle cell neoplasm, they are diagnostically treacherous, sometimes delaying antimicrobial therapy or resulting in unnecessary surgery. We report a case of a spindle pseudotumor of the lung resulting from Histoplasma capsulatum infection, a previously unreported cause of a spindle cell lesion in the lung. The patient was a 67-year-old woman in whom positron emission tomography-positive nodules developed in the left lung and left mediastinum. The patient had undergone renal transplantation and was receiving immunosuppressive therapy with mycophenolate, tacrolimus, and low-dose prednisone. Infection with H capsulatum was confirmed by culture of pleural effusion fluid, DNA probe analysis of the pleural fluid culture isolate, urinary Histoplasma antigen detection, and Grocott methenamine silver stains of tissue sections. To our knowledge, this is the first case of a spindle cell "pseudotumor" of the lung resulting from histoplasmosis. It highlights the importance of performing special stains for organisms when evaluating pulmonary spindle cell lesions in an immunocompromised host.

Original languageEnglish (US)
Pages (from-to)410-415
Number of pages6
JournalAmerican Journal of Clinical Pathology
Volume136
Issue number3
DOIs
StatePublished - Sep 2011

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Keywords

  • Histoplasmosis
  • Lung pseudoneoplasm
  • Pseudotumor
  • Spindle cell lesion

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Gravdahl, D. J., Gardetto, J. S., Hurley, J. R., Tazelaar, H. D., Koontz, P. W., & Leslie, K. O. (2011). Pulmonary histoplasmosis producing a spindle cell "pseudotumor". American Journal of Clinical Pathology, 136(3), 410-415. https://doi.org/10.1309/AJCP13KZDDJCICAT