CTICasesDisseminated Blastomycosis
Imaging findings
Brain MRI with contrast shows a well-defined, intensely enhancing mass in the right cerebellar hemisphere causing mass effect on the fourth ventricle, with surrounding vasogenic edema and white matter changes. Chest radiograph and abdominal CT show a corresponding large mass in the posterior segment of the right lower lobe with a trace pleural effusion.
Key takeaways
Blastomycosis is a systemic pyogranulomatous infection caused by the dimorphic fungus Blastomyces dermatitidis, endemic to the Ohio and Mississippi River valleys, Great Lakes region, and southeastern US. While pulmonary involvement is most common, hematogenous dissemination can occur, particularly to the skin, bones, and central nervous system (CNS), mimicking primary brain tumors or metastases.
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