Difficult to diagnose: An unusual cause of cavitary lung lesion

Abstract

Objective: Unknown ethiology Background: Cavitary lung lesions are commonly identified on thoracic imaging, but typically require further workup for de-finitive diagnosis. Case Report: Here, we present the case of a 40-year-old Middle Eastern male who presented with an unusual cause of cavi-tary lung lesion with associated pleural mass and pleural thickening. He underwent bronchoscopic biopsy and computer tomography (CT)-guided core needle biopsy, both of which were non-diagnostic. Surgical biopsy sub-sequently revealed hyalinized necrotizing granulomatous tissue, consistent with histoplasmosis, and the patient was treated with itraconazole, which he responded well to. Conclusions: This case demonstrates the importance of identifying unusual causes of cavitary lung lesions and emphasizes the role of using proper tissue sampling for diagnosis.