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  • Title: Granulomatous Pneumocystis carinii pneumonia in three patients with the acquired immune deficiency syndrome.
    Author: Bleiweiss IJ, Jagirdar JS, Klein MJ, Siegel JL, Krellenstein DJ, Gribetz AR, Strauchen JA.
    Journal: Chest; 1988 Sep; 94(3):580-3. PubMed ID: 3261680.
    Abstract:
    Pneumocystis carinii pneumonia is a frequent manifestation of the acquired immune deficiency syndrome (AIDS). It usually presents radiologically as diffuse bilateral infiltrates and histologically as a foamy, eosinophilic intra-alveolar exudate containing the organisms' cysts. We recently studied two rare cases of P carinii pneumonia presenting as pulmonary nodules on chest x-ray films in two patients with AIDS. The corresponding histologies were a combination of the usual intra-alveolar pattern, with an alveolar and interstitial granulomatous appearance. Pneumocystis carinii was present in both areas and was the only organism found in the tissues examined. A third case presented with the more common radiographic appearance but also had a granulomatous histology. We conclude that P carinii pneumonia should be considered in the differential diagnosis of pulmonary nodules in immunocompromised patients and that pathologists should be aware of the possibility of a granulomatous reaction to this organism.
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