CTICasesPulmonary Syphilitic Gummas in Hodgkin's Disease
Imaging findings
CT chest in a patient with nodular sclerosing Hodgkin's lymphoma shows a large mediastinal mass, along with several separate, smooth, peripheral pulmonary nodules. Biopsy of a lingular nodule demonstrated non-caseating granulomatous inflammation, positive for Treponema pallidum (pulmonary gummas).
Key takeaways
Pulmonary gummas are a rare manifestation of tertiary syphilis, representing localized areas of granulomatous inflammation. In patients with known malignancies like Hodgkin's lymphoma, these lesions can be easily misdiagnosed as pulmonary metastases. Histopathological analysis is required to identify the spirochetes and avoid inappropriate cancer therapy.
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