Resection of a lung nodule infected with Schizophyllum commune initially suspected of being lung cancer

Abstract

We report a surgically treated case of nodular pulmonary mycosis caused by Schizophyllum commune. A 58-year-old woman underwent a medical examination and an abnormal shadow was pointed out on a chest radiograph. She visited a hospital and computed tomography revealed a pulmonary nodule with cavity in the right upper lobe of the lung. She was transferred to our hospital for further examination. A faint accumulation was detected on positron emission tomography and she underwent video-assisted thoracic surgery for both a definitive diagnosis and cure. No sign of malignancy was noted on intraoperative pathological examination, and wedge resection was performed. Pulmonary aspergillosis was initially suspected on further examination after surgery, and she underwent additional segmentectomy of right S¹+S ² to obtain a sufficient surgical margin and resolve the prolonged air leakage. It was not identified as Aspergillus sp. by a bacterial culture, and subsequent genomic analysis diagnosed Schizophyllum commune infection. The postoperative course was uneventful and there has been no sign of mycosis recurrence for five years since the surgery.