RESUMO
A 25-year-old man presented to the Emergency Department with thoracic pain and coughing after travelling through South America. Radiologic work-up revealed diffuse multifocal consolidations surrounded by a ground-glass halo and thoracic lymphadenopathy. A urine antigen test was positive for Histoplasma capsulatum, a fungus that is endemic in South America and which causes a severe pulmonary infection in 5% of the infected patients.
Assuntos
Dor no Peito/microbiologia , Histoplasma , Histoplasmose/complicações , Doença Relacionada a Viagens , Adulto , Tosse/microbiologia , Histoplasmose/diagnóstico , Humanos , Masculino , América do Sul , ViagemRESUMO
BACKGROUND: The most important differential diagnosis of a soft-tissue mass is soft-tissue sarcoma, and the diagnostic process should be aimed at diagnosing or excluding this. CASE DESCRIPTION: A 28-year-old man was referred to the surgeon with a progressive painless swelling on the right shoulder. Diagnostic imaging suggested a sarcoma with axillary lymphadenopathy. Repeatedly biopsy revealed a non-necrotizing granulomatous inflammation. A diagnosis of sarcoidosis was finally made, after exclusion of malignancy and infectious causes. CONCLUSION: When a patient presents with a soft-tissue mass, malignant causes such as soft-tissue sarcoma should be excluded. If pathological investigation reveals a granulomatous inflammation, a soft-tissue mass as a rare presentation of sarcoidosis should be considered. It is, however, important to first exclude a sarcoid-like reaction.
