Pulmonary Disease/Critical Care Medicine Fellowship Program, Orlando Regional Medical Center, Orlando, Florida, USA
Office of Faculty and Academic Affairs, University of Central Florida College of Medicine, Orlando, Florida, USA.
BMJ Case Rep. 2020 Nov 4;13(11):e237696. doi: 10.1136/bcr-2020-237696.
We present a case of persistent pleural masses with mediastinal adenopathy in an immunocompromised patient initially biopsied, diagnosed and treated for pneumonia, ultimately requiring surgical thoracoscopy to diagnose pulmonary histoplasmosis. We discuss the diagnostic approach for pleural masses in immunocompromised patients, the limitations of tissue sampling, interpretation and methodology, and pitfalls of testing in making a pathogen-specific diagnosis.
我们报告了一例免疫功能低下患者持续存在胸腔积液和纵隔淋巴结肿大的病例，该患者最初经活检、诊断和肺炎治疗，最终需要进行胸腔镜手术以诊断肺组织胞浆菌病。我们讨论了免疫功能低下患者胸腔积液的诊断方法、组织采样、解释和方法的局限性，以及在进行病原体特异性诊断时检测的陷阱。
