A Y P Bondoc1, D A White. 1. Memorial Sloan Kettering Cancer Center and Weill Medical College of Cornell University, 1275 York Avenue, New York, NY 10021, USA.
Abstract
BACKGROUND: A review was undertaken of the clinical features and results of diagnostic tests in non-HIV infected patients who developed granulomatous Pneumocystis carinii pneumonia (PCP). METHODS: A retrospective review was performed of the charts and radiographs of patients with a granulomatous reaction to P carinii identified from computerised pathology records at Memorial Sloan Kettering Cancer Center, a university affiliated tertiary care hospital. RESULTS: Three cases were identified; the incidence of granulomatous PCP was 3%. All patients had risk factors for PCP and had received high dose corticosteroids which had been stopped. Two patients had received chemotherapy. Presentation was insidious with only mild symptoms; only one patient had fever. Chest radiographs showed a reticulonodular pattern. Bronchoscopy was negative for PCP in all cases and open lung biopsy was necessary. CONCLUSION: A granulomatous pathological reaction to PCP occurs rarely in patients with malignancy. In these cases the clinical presentation may be atypical and bronchoscopy can be non-diagnostic.
BACKGROUND: A review was undertaken of the clinical features and results of diagnostic tests in non-HIV infectedpatients who developed granulomatous Pneumocystis carinii pneumonia (PCP). METHODS: A retrospective review was performed of the charts and radiographs of patients with a granulomatous reaction to P carinii identified from computerised pathology records at Memorial Sloan Kettering Cancer Center, a university affiliated tertiary care hospital. RESULTS: Three cases were identified; the incidence of granulomatous PCP was 3%. All patients had risk factors for PCP and had received high dose corticosteroids which had been stopped. Two patients had received chemotherapy. Presentation was insidious with only mild symptoms; only one patient had fever. Chest radiographs showed a reticulonodular pattern. Bronchoscopy was negative for PCP in all cases and open lung biopsy was necessary. CONCLUSION: A granulomatous pathological reaction to PCP occurs rarely in patients with malignancy. In these cases the clinical presentation may be atypical and bronchoscopy can be non-diagnostic.
Authors: S A Bozzette; F R Sattler; J Chiu; A W Wu; D Gluckstein; C Kemper; A Bartok; J Niosi; I Abramson; J Coffman Journal: N Engl J Med Date: 1990-11-22 Impact factor: 91.245
Authors: Natasha Sabur; Margaret M Kelly; M John Gill; Martha D Ainslie; Sachin R Pendharkar Journal: Can Respir J Date: 2011 Nov-Dec Impact factor: 2.409