Lymphoabdominal paracoccidioidomycosis simulating primary neoplasia of the biliary tract

Prado, Fábio Luis Silva do; Prado, Renata Silva do; Gontijo, Cecília Campos Valadares; Freitas, Ricardo Miguel Costa de; Pereira, Marta Máximo; Paula, Ivie Braga de; Pedroso, Ênio Roberto Pietra

doi:10.1007/s11046-005-2670-x

Cited by 13 publications

(10 citation statements)

References 4 publications

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“…Many reports have focused on the similarities between malignancy and paracoccidioidomycosis based on clinical manifestations like lymphoma or leukemia or primary malignancy of the biliary tract [5] in the acute/subacute form of this mycosis. Other carcinoma diagnoses-instead of this mycotic lesions-were reported, such as colon cancer in case of intestinal involvement [6], laryngeal or intra-oral carcinoma, in the oral and laryngeal involvement by this mycosis [7,8] and posterior fossa tumor in cases of cerebral paracoccidioidomycosis [9,10].…”

Section: Cancer or Paracoccidioidomycosis?mentioning

confidence: 99%

Neoplasia and paracoccidioidomycosis

et al. 2008

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Published studies on the association between cancer and paracoccidioidomycosis consist either isolated cases or clinical data based on hospital cohorts of paracoccidioidomycosis. The frequency of neoplasia in series of ! 80 patients with paracoccidioidomycosis ranges from 0.16 to 14.1%, mean of 3.96%. There are only two retrospective controlled studies, one of them showing greater incidence of carcinoma in biopsy and necropsy samples of paracoccidioidomycosis (12 cases in 147 patients with the mycosis: 8.2%) than in the necropsies of the control group (320 cases in 7,302 necropsies: 4.9%). In the other, 22,409 autopsies were reviewed and 4,372 cases of cancer were found; of the 85 patients with paracoccidioidomycosis, 12 were diagnosed with cancer. No differences were observed in the frequency of malignancies between the group of patients with paracoccidioidomycosis (14.1%) and the control group (19.5%). Considering all the reported cases, carcinoma was more frequent than hematological malignancies, and was more often found at the same site or in a neighboring site affected by the mycosis, usually occurring after the diagnosis of the mycosis. Commonly, the basic cause of death was related to secondary infections or neoplasia. Lymphoma was associated with poorly organized rich in fungi granuloma. The clinical course and mortality were related to the cancer evolution or secondary infections and was worse in lymphoid series, metastatic carcinoma or in patients under cytotoxic chemotherapy. Additionally, as in several cases the clinical and histopathological data

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Section: Cancer or Paracoccidioidomycosis?mentioning

confidence: 99%

Neoplasia and paracoccidioidomycosis

et al. 2008

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“…As a chronic systemic mycosis it carries a high morbidity and mortality, especially in cases of diffuse systemic involvement 14 or when associated with immune compromising conditions [15][16][17] , as also noticed with other endemic fungal diseases [18][19][20] . The prevalence of PCM in Brazil is estimated by regional serological surveys or epidemiological mortality reviews 2,[21][22][23] .…”

Section: Discussionmentioning

confidence: 99%

Pulmonary paracoccidoidomycosis: radiology and clinical-epidemiological evaluation

Freitas

Prado

Prado³

et al. 2010

Rev. Soc. Bras. Med. Trop.

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Introduction:The purpose of this study was to compare respiratory signs and symptoms between patients with and without chest X-ray abnormalities in order to establish the meaning of radiographic findings in pulmonary PCM diagnosis. Methods: The epidemiological, clinical and radiological lung findings of 44 patients with paracoccidiodomycosis (PCM) were evaluated. Patients were divided into two groups of 23 and 21 individuals according to the presence (group 1) or absence (group 2) of chest X-ray abnormalities, respectively, and their clinical data was analyzed with the aid of statistical tools. Results: As a general rule, patients were rural workers, young adult males and smokers -group 1 and 2, respectively: males (91.3% and 66.7%); mean age (44.4 and 27.9 year-old); smoking (34.7% and 71.4 %); acute/subacute presentation (38.1% and 21.7%); chronic presentation (61.9% and 78.3%). The most frequent respiratory manifestations were -group 1 and 2, respectively: cough (25% and 11.4%) and dyspnea (22.7% and 6.8%). No statistical difference was observed in pulmonary signs and symptoms between patients with or without radiographic abnormalities. The most frequent radiological finding was nodular (23.8%) or nodular-fibrous (19%), bilateral (90.5%) and diffuse infiltrates (85.7%). Conclusions: Absence of statistical difference in pulmonary signs and symptoms between these two groups of patients with PCM indicates clinical-radiological dissociation. A simplified classification of radiological lung PCM findings is suggested, based on correlation of these data and current literature review.

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“…3,9,11 Abdominal involvement in PCM is normally seen in the subacute form, with a wide variety of clinical manifestations, including nausea, vomiting, weight loss, weakness, pruritus, jaundice, choluria, fecal acholia, ascites, abdominal pain and hepatosplenomegaly. 5,12,13 Jaundice in PCM is reported as a severe and late manifestation of the disease, which is associated with a poor prognosis. 13 It is normally caused by extrinsecal compression of the common bile duct by lymph nodes.…”

Section: A B Cmentioning

confidence: 99%

“…5,12,13 Jaundice in PCM is reported as a severe and late manifestation of the disease, which is associated with a poor prognosis. 13 It is normally caused by extrinsecal compression of the common bile duct by lymph nodes. 7 The enlarged intra-abdominal lymph nodes may coalesce, producing solid masses, which mimic intra-abdominal tumors, as in our case.…”

Section: A B Cmentioning

confidence: 99%

Paracoccidioidomycosis in an Elderly Simulating Cholangiocarcinoma

Guerra

Simões

Valle

et al. 2021

SPDV

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Paracoccidioidomycosis, the most prevalent deep mycosis in Latin America, is caused by dimorphic species of the genus Paracoccidioides, affects predominantly male rural workers between 30-50 years of age and is an important cause of morbidity and mortality. It can present in two clinical forms: acute/subacute or chronic. In rare cases paracoccidioidomycosis may simulate neoplasia and must be considered as a differential diagnosis of intra-abdominal tumors in endemic areas. We report an exuberant case of subacute paracoccidioidomycosis in an elderly lady, although it is more frequent in the juvenile form. Multiple facial skin lesions were associated with a wasting syndrome and extensive adenopathy including in the hepatic area, causing bile duct dilatation simulating a cholangiocarcinoma. Skin histopathology was diagnostic and antifungal treatment allowed complete resolution of cutaneous and systemic lesions, thus highlighting the merit of the dermatologist, who was fundamental for the conclusive diagnosis and institution of specific therapy, resulting in a favorable outcome.

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Lymphoabdominal paracoccidioidomycosis simulating primary neoplasia of the biliary tract

Cited by 13 publications

References 4 publications

Neoplasia and paracoccidioidomycosis

Neoplasia and paracoccidioidomycosis

Pulmonary paracoccidoidomycosis: radiology and clinical-epidemiological evaluation

Paracoccidioidomycosis in an Elderly Simulating Cholangiocarcinoma

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