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Mycopathologia

, Volume 92, Issue 3, pp 179–188 | Cite as

Pathology of the human pulmonary paracoccidioidomycosis

  • R. M. Tuder
  • R. El Ibrahim
  • C. E. Godoy
  • T. De Brito
Article

Abstract

Lungs of twelve patients with chronic paracoccidioidomycosis (Pb) were studied in an attempt to understand the pathogenesis of the pulmonary disease. Ribbons of the lung parenchyma including the hilar region and directed towards apical, basal and lateral regions were subdivided into sections from the hilar, intermediate and peripheral segments. The following histopathological reactions directly or indirectly related to P. brasiliensis were described and analysed in relation to the number of slides studied and the pulmonary region involved: (1) pneumonic reaction; (2) early granulomatous formation; (3) mature and healed granulomata; (4) mixed pattern (early and mature granuloma in the same pulmonary area visualized in the slide); (5) pulmonary fibrosis.

It was concluded that chronic pulmonary Pb is a recurrent disease affecting equally both lungs. Fibrosis was connected mainly with the progressive evolution of the granulomata towards cicatrization and to a lesser degree probably to a direct induction by the fungi. Based chiefly on the tendency of the fibrosis to run around bronchi and to make up septa interconnecting bronchi and vessels it was hipothesized that these findings were the result of a previous chronic specific lymphangitis by the fungi. Hilar fibrosis would be the result of this lymphangitis and/or of the progression of the specific granulomatous reaction seen in the hilar lymph nodes.

Non specific forms of arteritis and areas of destructive emphysema related to granulomatous inflammation and fibrosis were described. Three cases developed pulmonary hypertension.

Keywords

Pulmonary Hypertension Pulmonary Fibrosis Lung Parenchyma Hilar Region Granulomatous Formation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Martinus Nijhoff/Dr W. Junk Publishers 1985

Authors and Affiliations

  • R. M. Tuder
    • 1
  • R. El Ibrahim
    • 1
  • C. E. Godoy
    • 1
  • T. De Brito
    • 1
  1. 1.Department of Pathology, São Paulo Medical SchoolUniversity of São PauloSão PauloBrazil

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