The association of adenocarcinoma of the lung and blastomycosis from an unusual geographical location.

A case of North American blastomycosis acquired outside the American continent and presenting with a left hilar mass is reported. The progressive hilar enlargement, despite adequate antifungal treatment, raised the possibility of drug resistance, concomitant tuberculosis and carcinoma. Non-invasive diagnostic studies including cultures, cytology and fibreoptic bronchoscopy were negative. On thoracotomy, both blastomy cosis and a poorly undifferentiated adenocarcinoma were evident.