CTICasesPulmonary Histoplasmosis
Imaging findings
High-resolution CT demonstrates a solitary pulmonary nodule associated with bronchovascular beading, consisting of satellite micronodules clustered along the adjacent bronchovascular bundles directed toward the hilum. There is also calcification of the left hilar and subcarinal lymph nodes. Surgical wedge resection confirmed necrotizing granulomatous inflammation with fungal yeast morphologically consistent with Histoplasma capsulatum.
Key takeaways
Pulmonary histoplasmosis can present with classic radiologic findings of a well-defined nodule accompanied by bronchovascular beading and satellite micronodules directed toward the hilum. Recognizing this benign, healed endemic fungal pattern is crucial to avoid unnecessary interventions, although surgical biopsy or wedge resection is sometimes performed due to concern for a primary lung neoplasm.
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