Mediastinal and pulmonary entomophthoromycosis with superior vena cava syndrome: case report

João Carlos Coelho Filiio, Jorge Pereira, Álvaro Rabello Júnior

The first case of mediastinal and pulmonary entomophthoromycosis with superior vena cava syndrome is reported. The patient presented with a history of edema of the face, neck and upper limbs as well as collateral circulation in the anterior wall of the chest. Histological examination of tissue from mediatinum revealed a granulomatous reaction with microabscesses surrounded by eosinophilic amorphous material and with broad hyphae in the center. Culture was not performed because a preliminary diagnosis of non-Hodgkin's malignant lymphoma was made. Surgical correction of the obstructed area was performed and the patient was successfully treated with potassium iodide. The authors propose that mediastinal entomophthoromycosis must be considered in the differential diagnosis of diseases causing superior vena cava syndrome in tropical and sub-tropical regions. This case enlarges the spectrum of clinical manifestations of the zigomycosis caused by Entomophthoraceae.