High-resolution CT findings of 77 patients with untreated pulmonary paracoccidioidomycosis.

OBJECTIVE: The objective of our study was to describe the high-resolution CT findings of 77 patients with pulmonary paracoccidioidomycosis (PCM) who had not yet been treated for PCM. MATERIALS AND METHODS: The high-resolution CT scans of 77 consecutive patients with proven pulmonary PCM were reviewed by two chest radiologists, and decisions regarding the CT findings were reached by consensus. Seventy-one of the patients were men and six were women, with an average age of 49 years. The criteria for interpretation of the high-resolution CT scans are defined in the Fleischner Society's Glossary of Terms. RESULTS: The most frequent high-resolution CT findings were ground-glass attenuation areas (58.4%), small centrilobular nodules (45.5%), cavitated nodules (42.9%), large nodules (41.6%), parenchymal bands (33.8%), areas of cicatricial emphysema (33.8%), interlobular septal thickening (31.2%), and architectural distortion (29.9%). Most of these high-resolution CT findings predominated at the periphery (53%) and posterior (88%) regions involving all lung zones, with discrete predominance in the middle zones (35%). CONCLUSION: The high-resolution CT findings of patients with pulmonary PCM who have not yet been treated consist of ground-glass attenuation areas associated with small centrilobular nodules, cavitated nodules, large nodules, parenchymal bands, and areas of cicatricial emphysema. These abnormalities are usually distributed in the posterior and peripheral regions of the lungs, with discrete predominance in the middle lung zones.