[Pulmonary microcalcification with miliary foreign-body granulomas. Residuals of cured Pneumocystis carinii pneumonia in AIDS]. / Pulmonale Mikrokalzifikationen mit miliaren Fremdkörpergranulomen. Residuen einer abgeheilten Pneumocystis-carinii-Pneumonie bei AIDS.

Pneumocystis carinii pneumonia (PCP) is one of the most frequent infectious lung diseases in immunocompromised patients, especially in AIDS cases. The present case report describes pulmonary miliary microcalcifications with and without foreign-body reaction in a patient with successfully treated PCP who was known to have AIDS. This form of residues of completely healed PCP tends to be rare. Other infectious granulomas, foreign-body granulomas and sarcoidosis must be differentially diagnosed. After cautious decalcification, pneumocysts can be demonstrated with methamine silver (Grocott). It is important to be aware that PCP can also undergo spontaneous cure, so that miliary microcalcifications may then be the sole pointer to the presence of AIDS.

[Tumor simulating primary pulmonary cryptococcosis in an immunocompetent patient. A contribution to differential diagnosis]. / Als Tumor imponierende primäre pulmonale Kryptokokkose bei einer immunkompetenten Patientin. Ein Beitrag zur Differentialdiagnose.

Case report of a primary cryptococcosis of the lung in a 78-year old non-immunocompromised female. The patient presented with a mass in the right upper lobe, highly suspicious of lung cancer. Cryptococcus finally was detected on repeated biopsies from ulcerated and necrotic bronchial mucosa. A clinical work-up showed no evidence of dissemination and no signs of immunoinsufficiency. Mass reduction in the lung was achieved under therapy with fluconazol.

[Histomorphological differential diagnosis between occupational and "idiopathic" pulmonary fibroses]. / Histomorphologische Differentialdiagnose zwischen berufsbedingten und "idiopathischen" Lungenfibrosen.

Pulmonary fibroses are terminal stages of exposure to a whole series of very diverse noxae. Both occupational and nonoccupational causes must be distinguished. Finally, there is the large collective category "idiopathic" fibroses. In terms of their systematics, fibroses can be classified in five largegroups. The classification criteria are etiological when the causes are known, and morphological-descriptive in cases of idiopathic fibrosis. Occupational and "idiopathic" fibroses often cannot be distinguished in biopsy material because of their great histomorphological similarity. In such circumstances, the result of further analyses is crucial. For this reason, the possibility that an occupational pulmonary fibrosis is present must also be considered even in "idiopathic" pulmonary fibroses in order to arrange for further analyses such as BAL, ashing and energy-dispersive X-ray analysis to be performed.