Pulmonary histoplasmoma in Rio Grande do Sul

Abstract

A retrospective analysis of sixteen patients with pulmonary nodules diagnosed as histoplasmoma by histopathologic evidence of Histoplasma capsulatum var capsulatum was done in an endemic area for histoplasmosis. Brazilian literature was reviewed. All patients were white, nine were men, mean age at diagnosis was 50.8 years. Six (37.5%) patients had a relevant epidemiologic story. The pulmonary nodules were 0.7-2.7 cm in diameter, presenting as granulomatous lesions with caseous necrosis. Twelve (75%) patients had solitary nodules. Histoplasmoma as a rule is a solitary nodule of up to 3 cm in an asymptomatic patient. The diagnosis is made from histopathologic evidence of the fungus, which is accomplished using a special fungus stain, Gomori-Grocott methenamine silver. Cultures or seromycology do not help the diagnosis.