The Radiology Corner. Gastrointestinal histoplasmosis, roentgenographic, clinical and pathological correlation.

Five cases with gastrointestinal histoplasmosis are presented. Gastrointestinal involvement is moderately frequent during the hematogenous dissemination of histoplasmosis. Depending on the underlying pathological changes, six roentgenographic patterns can be identified: 1. malabsorptive; 2. ulcerative; 3. polypoid; 4. granulomatous; 5. tumefactive and 6. compressive. Perforation, hemorrhage, obstruction and erroneous diagnosis for ulcerative colitis, Crohn's disease or carcinoma are the major complications. Histoplasmosis should be included in the differential diagnosis of diseases presenting with a malabsorption pattern, gastrointestinal polyposis, ulcerative and granulomatous gastrointestinal diseases and carcinoma, particularly if pulmonary lesions co-exist.