Challenging granulomatous differential diagnosis of CNS lesions in a 75-year-old patient with indolent lymphoma

Thurner, Lorenz and Melivadze, Ketevani and Matschke, Jakob and Topalidis, Theodoros and Bachhuber, Armin and Speicher, Tilman and Rosar, Florian and Reischl, Udo and Traenkenschuh, Wolfgang and Friesenhahn-Ochs, Bettina and Fries, Peter and Becker, Soeren L. and Fleser, Octavian (2024) Challenging granulomatous differential diagnosis of CNS lesions in a 75-year-old patient with indolent lymphoma. FRONTIERS IN IMMUNOLOGY, 15: 1462310. ISSN 1664-3224

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Abstract

We report here on a patient with concomitant indolent lymphoma who showed a rapid progressive deterioration of his general condition and emerging neurological symptoms. The combination of severe B symptoms with hypermetabolic involvement of the adrenal glands and multiple central nervous system (CNS) lesions initially suggested a malignant disease. However, when the patient presented to us with biopsy results from one of the CNS lesions, the biopsy revealed granulomatous inflammation but no evidence of malignancy. This case illustrates the difficulties and challenges of diagnosing in a timely manner Histoplasma capsulatum, an ultra rare infectious disease in Europe.

Item Type: Article
Uncontrolled Keywords: ; histoplasma; brain manifestations; adrenal gland insufficiency; B-NHL; immune deficiency
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene
Depositing User: Dr. Gernot Deinzer
Date Deposited: 28 Jan 2026 07:33
Last Modified: 28 Jan 2026 07:33
URI: https://pred.uni-regensburg.de/id/eprint/65158

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