ABSTRACT
Good's syndrome is extremely rare. This adult-onset condition is characterized by a thymoma with immunodeficiency, low B- and T-cell counts, and hypo-gammaglobulinemia. The initial clinical presentation is either a mass-lesion thymoma or a recurrent infection. Patients with Good's syndrome are very susceptible to infections; common respiratory and opportunistic infections can be life-threatening. There are no reports of granulomatous lung disease in patients with Good's syndrome, although it has been observed in patients with common variable immunodeficiency, of which Good's syndrome is a subset. We describe a 53-year-old male thymoma patient who presented with respiratory symptoms caused by granulomatous lung disease and an opportunistic infection. He died of uncontrolled fungal infection despite repeated intravenous immunoglobulin and supportive care. Clinicians should look for evidence of immunologic dysfunction in thymoma patients presenting with severe recurrent infections, especially opportunistic infections.
Subject(s)
Humans , Male , Middle Aged , Fatal Outcome , Granuloma, Respiratory Tract/diagnosis , Immunologic Deficiency Syndromes/complications , Lung Diseases/diagnosis , Thymoma/complications , Thymus Neoplasms/complicationsABSTRACT
Granulomatose broncocêntrica é um achado histopatológico descritivo, caracterizado pela inflamação granulomatosa necrosante, centrada em brônquios e bronquíolos, e que ocorre associada a doenças infecciosas, imunológicas e neoplásicas, ou de forma idiopática. Este trabalho relata o caso de uma jovem não asmática de 26 anos com dor torácica, febre e tosse produtiva havia um mês, que apresentou consolidação e cavitação em segmento lingular, observadas na radiografia e na tomografia computadorizada de tórax. Punção aspirativa transbrônquica evidenciou lesão inflamatória inespecífica, sem etiologia identificada. O exame histológico de material obtido por biópsia pulmonar a céu aberto foi compatível com granulomatose broncocêntrica idiopática. Após tratamento com prednisona, houve melhora clínica, sem recidivas.