Varicella-zoster Virus Related Pulmonary Granulomas in Which Varicella-zoster Virus DNA Was Demonstrated in a Thoracoscopic Lung Biopsy Specimen

Takeshi Isobe; Jyunro Umemoto; Misato Kobayashi; Takae Okuno; Youhei Shiratsuki; Akari Kodama; Mika Nakao; Yoshihiro Amano; Takamasa Hotta; Megumi Hamaguchi; Tamio Okimoto; Shunichi Hamaguchi; Yukari Tsubata

doi:10.2169/internalmedicine.2021-18

CASE REPORTS

Varicella-zoster Virus Related Pulmonary Granulomas in Which Varicella-zoster Virus DNA Was Demonstrated in a Thoracoscopic Lung Biopsy Specimen

Takeshi Isobe, Jyunro Umemoto, Misato Kobayashi, Takae Okuno, Youhei Shiratsuki, Akari Kodama, Mika Nakao, Yoshihiro Amano, Takamasa Hotta, Megumi Hamaguchi, Tamio Okimoto, Shunichi Hamaguchi, Yukari Tsubata

Author information

Takeshi Isobe
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Jyunro Umemoto
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Misato Kobayashi
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Takae Okuno
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Youhei Shiratsuki
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Akari Kodama
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Mika Nakao
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Yoshihiro Amano
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Takamasa Hotta
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Megumi Hamaguchi
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Tamio Okimoto
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Shunichi Hamaguchi
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan
Yukari Tsubata
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Japan

Keywords: varicella pneumonia, pulmonary granulomas, malignant lymphoma

JOURNAL OPEN ACCESS

2019 Volume 58 Issue 14 Pages 2101-2105

DOI https://doi.org/10.2169/internalmedicine.2021-18

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Abstract

A 43-year-old man with malignant lymphoma who had been treated with the cyclosphamide, vincrstine, procarbazine, and prednisolone (C-MOPP) regimen was admitted to our hospital with skin eruption. He was diagnosed to have varicella, and treatment with acyclovir and immune globulin was started. Chest computed tomography revealed multiple nodules in the both lung fields. Diagnostic thoracoscopic lung biopsy specimens revealed granuloma formation, and polymerase chain reaction testing revealed the presence of varicella-zoster virus DNA in the granulomatous tissue. It was unusual for the lung nodule in varicella pneumonia to increase in size over time in a patient who had undergone antiviral therapy, while also demonstrating multiple granulomas.

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