Journal of thoracic disease · 2026
Clinical and computed tomography (CT) features of nodular pulmonary histoplasmosis.
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Li Fei, He Yanli, Li Yanyan, Qu Xiaoyan, Yu Mei, Wang Wen, Li Gangfeng, Li Wei
Аннотация
BACKGROUND: Pulmonary histoplasmosis is a fungal infection caused by Histoplasma capsulatum. Although endemic in certain regions, it is increasingly reported worldwide. Nodular pulmonary histoplasmosis (NPHP) represents a distinct form of the disease, characterized by the formation of granulomatous nodules within the lung parenchyma of the host. Clinically, patients may present with nonspecific symptoms or remain entirely asymptomatic, and the condition can mimic various other pulmonary diseases. High-resolution computed tomography (HRCT) plays a crucial role in identifying characteristic nodular patterns, which aids in differentiating NPHP from other pulmonary nodules. This study aimed to analyze the HRCT features and clinical characteristics of patients with NPHP to enhance clinicians' awareness of this entity in the differential diagnosis of pulmonary nodules.
METHODS: A retrospective analysis was conducted on the clinical data, chest computed tomography (CT) imaging findings, and pathological features of 23 patients diagnosed with NPHP in our hospital from January 2014 to May 2024.
RESULTS: Among the 23 patients, males were more common (16 cases, 69.57%). The average age of NPHP was 50.30±13.07 years, and most of them had no clinical symptoms. NPHP was observed in the left lung in 9 cases (39.13%) and in the right lung in 14 cases (60.87%). Additionally, the minimum distance from the pleura measured approximately 4.28±5.45 mm. Twenty-two cases (95.65%) showed solid nodules (SNs), 17 cases (73.91%) were isolated lesions in the lungs, 15 cases (65.22%) had round-shaped lesions, 19 cases (82.61%) had clear borders, 10 cases (43.48%) exhibited lobulated growth patterns, 6 cases (26.09%) had spiculated margins, and 15 cases (65.22%) demonstrated adhesion to the pleura.
CONCLUSIONS: NPHP exhibits a higher prevalence among male patients. The majority of cases are asymptomatic and bilateral lungs can be involved. Lesions are predominantly subpleural and adhere to the pleura, presenting as solitary, well-defined SNs with a round-like appearance. Abnormal bronchi, vascular signs, cavities, and calcifications are infrequently observed.
METHODS: A retrospective analysis was conducted on the clinical data, chest computed tomography (CT) imaging findings, and pathological features of 23 patients diagnosed with NPHP in our hospital from January 2014 to May 2024.
RESULTS: Among the 23 patients, males were more common (16 cases, 69.57%). The average age of NPHP was 50.30±13.07 years, and most of them had no clinical symptoms. NPHP was observed in the left lung in 9 cases (39.13%) and in the right lung in 14 cases (60.87%). Additionally, the minimum distance from the pleura measured approximately 4.28±5.45 mm. Twenty-two cases (95.65%) showed solid nodules (SNs), 17 cases (73.91%) were isolated lesions in the lungs, 15 cases (65.22%) had round-shaped lesions, 19 cases (82.61%) had clear borders, 10 cases (43.48%) exhibited lobulated growth patterns, 6 cases (26.09%) had spiculated margins, and 15 cases (65.22%) demonstrated adhesion to the pleura.
CONCLUSIONS: NPHP exhibits a higher prevalence among male patients. The majority of cases are asymptomatic and bilateral lungs can be involved. Lesions are predominantly subpleural and adhere to the pleura, presenting as solitary, well-defined SNs with a round-like appearance. Abnormal bronchi, vascular signs, cavities, and calcifications are infrequently observed.