AUTHOR=Thurner Lorenz , Melivadze Ketevani , Matschke Jakob , Topalidis Theodoros , Bachhuber Armin , Speicher Tilman , Rosar Florian , Reischl Udo , Tränkenschuh Wolfgang , Friesenhahn-Ochs Bettina , Fries Peter , Becker Sören L. , Fleser Octavian 

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

JOURNAL=Frontiers in Immunology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2024.1462310

DOI=10.3389/fimmu.2024.1462310

ISSN=1664-3224

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.