Pulmonary foreign body granulomatosis in a chronic user of powder cocaine

Pulmonary foreign body granulomatosis in a chronic user of powder cocaine

Alternative title Granulomatose pulmonar de corpo estranho em um usuário crônico de cocaína em pó
Author Costa Junior, Altair da Silva Autor UNIFESP Google Scholar
Bachichi, Thiago Autor UNIFESP Google Scholar
Holanda, Caio Autor UNIFESP Google Scholar
De Rizzo, Luiz Augusto Lucas Martins Autor UNIFESP Google Scholar
Abstract We describe the case of a 33-year-old man, a chronic user of powder cocaine, who presented with dyspnea, fever, night sweats, and significant weight loss. Chest HRCT revealed centrilobular nodules, giving an initial impression of miliary tuberculosis. Therefore, he was started on an empirical, four-drug antituberculosis treatment regimen. Four weeks later, despite the tuberculosis treatment, he continued to have the same symptoms. We then performed transbronchial lung biopsy. Histopathological analysis of the biopsy sample revealed birefringent foreign body granuloma. A corroborative history of cocaine snorting, the presence of centrilobular nodules, and the foreign body-related histopathological findings led to a diagnosis of pulmonary foreign body granulomatosis. This report underscores the fact that pulmonary foreign body granulomatosis should be included in the differential diagnosis of clinical profiles resembling tuberculosis.

Descrevemos o caso de um homem de 33 anos de idade, usuário crônico de cocaína em pó, que apresentava dispneia, febre, sudorese noturna e perda de peso significativa. A TCAR de tórax revelou nódulos centrolobulares, dando uma impressão inicial de tuberculose miliar. Por isso, o paciente passou a receber tratamento empírico com quatro tuberculostáticos. Quatro semanas depois, apesar do tratamento antituberculose, o paciente continuou a apresentar os mesmos sintomas. Foi então realizada a biópsia pulmonar transbrônquica. A análise histopatológica da amostra obtida revelou granuloma de corpo estranho birrefringente. A história de uso de cocaína por inalação, a presença de nódulos centrolobulares e os achados histopatológicos de corpos estranhos confirmaram o diagnóstico de granulomatose pulmonar de corpo estranho. Este relato destaca o fato de que a granulomatose pulmonar de corpo estranho deve ser incluída no diagnóstico diferencial de perfis clínicos que se assemelham a tuberculose.
Keywords Lung
Granuloma, foreign-body
Cocaine-related disorders
Pulmão
Granuloma de corpo estranho
Transtornos relacionados ao uso de cocaína
xmlui.dri2xhtml.METS-1.0.item-coverage Brasilia Df
Language Portuguese
English
Date 2016
Published in Jornal Brasileiro De Pneumologia. Brasilia Df, v. 42, n. 6, p. 444-446, 2016.
ISSN 1806-3713 (Sherpa/Romeo, impact factor)
Publisher Soc Brasileira Pneumologia Tisiologia
Extent 444-446
Origin http://dx.doi.org/10.1590/S1806-37562015000000269
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000390977700012
SciELO ID S1806-37132017000400320 (statistics in SciELO)
URI https://repositorio.unifesp.br/handle/11600/56772

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