CTICasesCoccidioidomycosis
Imaging findings
Chest CT demonstrates a focal, lobulated, and FDG-avid consolidative mass in the peripheral right upper lobe, with a patent bronchus coursing through it. Spherules filled with endospores are identified on biopsy of the hypermetabolic paratracheal lymph nodes.
Key takeaways
Primary coccidioidomycosis can present as a solitary consolidative pulmonary mass with regional lymphadenopathy, mimicking bronchogenic carcinoma on CT and PET. Histological identification of Coccidioides spherules containing endospores within biopsied lymph nodes is diagnostic, allowing differentiation from malignancy and steering therapy toward antifungals.
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