Paracoccidioidomycosis: High-resolution computed tomography–pathologic correlation

Authors: Edson Marchiori, Paulo Marcos , Claudia Mauro Manoa, Gláucia Zanetti, Dante L. Escuissato, Arthur Soares Souza Jr.



Objective


The purpose of this study was to describe the high-resolution computed tomography (HRCT) features of pulmonary paracoccidioidomycosis and to correlate them with pathologic findings.
Methods

The study included 23 adult patients with pulmonary paracoccidioidomycosis. All patients had undergone HRCT, and the images were retrospectively analyzed by two chest radiologists, who reached decisions by consensus. An experienced lung pathologist reviewed all pathological specimens. The HRCT findings were correlated with histopathologic data.

Results:


The predominant HRCT findings included areas of ground-glass opacities, nodules, interlobular septal thickening, airspace consolidation, cavitation, and fibrosis. The main pathological features consisted of alveolar and interlobular septal inflammatory infiltration, granulomas, alveolar exudate, cavitation secondary to necrosis, and fibrosis.

Conclusion


Paracoccidioidomycosis can present different tomography patterns, which can involve both the interstitium and the airspace. These abnormalities can be pathologically correlated with inflammatory infiltration, granulomatous reaction, and fibrosis.