Phan Tina C L, Hundman Chloe N, Thomas-Gosain Neena, Jackson Christopher D
Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Department of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
J Community Hosp Intern Med Perspect. 2025 May 5;15(3):111-115. doi: 10.55729/2000-9666.1484. eCollection 2025.
A 67-year-old male patient presented with anorexia, weight loss, skin masses, and flank pain over the past three months. Imaging revealed a lung mass and a cystic lesion in the pancreatic head. After initial diagnostic work-up and clinical deterioration, broad based budding, seen on pathology, led to a diagnosis of disseminated blastomycosis. After receiving a 14-day course of liposomal amphotericin B followed by itraconazole, the patient showed significant clinical improvement. We reviewed all disseminated blastomycosis cases in the medical literature involving gastrointestinal organs. Although pancreatic involvement is rare, we suggest that it should be suspected in those with a rapidly growing pancreatic mass even in immunocompetent patients. Finally, tissue biopsy should be obtained expeditiously, but repeat biopsy may be indicated if initial results are negative and clinical suspicion remains high.
一名67岁男性患者在过去三个月中出现厌食、体重减轻、皮肤肿块和侧腹痛。影像学检查发现肺部有肿块，胰头有囊性病变。经过初步诊断检查和临床病情恶化后，病理检查发现广泛的芽生，从而诊断为播散性芽生菌病。在接受了14天的脂质体两性霉素B治疗，随后服用伊曲康唑后，患者临床症状有显著改善。我们回顾了医学文献中所有涉及胃肠道器官的播散性芽生菌病病例。虽然胰腺受累很少见，但我们建议，即使在免疫功能正常的患者中，对于胰腺肿块迅速增大的患者也应怀疑此病。最后，应尽快进行组织活检，但如果初始结果为阴性而临床怀疑仍然很高，则可能需要再次活检。
