Mediastinal and cervical histoplasmosis simulating malignancy.

A 12-year-old boy had a purulent mass in the anterior cervical region in association with an anterior mediastinal mass caused by Histoplasma capsulatum. The cervical mass probably represented spread of the disease, perhaps along the same pathways followed in Hodgkin's disease and other conditions that are known to involve the anterior mediastinum and the anterior cervical nodes simultaneously. An infectious disease (histoplasmosis) can cause a constellation of symptoms suggestive of a lymphoma or other malignancy.