Granulomatous Pneumocystis carinii pneumonia in patients with malignancy
- Memorial Sloan Kettering Cancer Center and Weill Medical College of Cornell University, New York, New York
- Correspondence to:
Dr D A White, Memorial Hospital, 1275 York Avenue, New York, New York 10021, USA;
whited{at}mskcc.org
- Accepted 22 November 2001
- Revised 1 November 2001
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.
