Abstract
Eight cases of primary pulmonary blastomycosis, with generalized disease in four, are presented. In a ninth case, the relation between laryngeal and pulmonary lesions could not be determined from the clinical history. In the tenth case, that of a woman with unique and apparently metastatic blastomycosis of the breast, no lesions in the skin, lungs, or other organs could be demonstrated. The early stage of blastomycotic pneumonia is of an exudative purulent type, later becoming of mixed purulent granulomatous character with true abscess formation. Caseous-like foci may develop owing to inspissation and homogenization of suppurative liquefaction, accompanied by fibrous encapsulation. Fibrous transformation of epitheloid-cell granulomas and scarring characterize the late and healing stages of the process. In contradistinction to the rare primary cutaneous blastomycosis, the involvement of the regional lymph nodes in primary pulmonary lesions is not constant. The same appears to be true in several other fungous diseases, except for histoplasmosis, in which, as in tuberculosis, the typical primary complex is the rule. Calcification, if it occurs at all, does not appear to be a regular feature in blastomycosis.
Published Version
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