PMC6011135_01
7 year old male anterior to posterior chest radiograph with mediastinal fullness/mass.
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A chest radiograph showed a para-tracheal mass, see Fig. 1.
Transverse chest CT non lung view revealing mediastinal chest mass 31.2 mm x 27 mm without obstruction.
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Upon admission a CT scan was performed, see Fig. 2.
Biopsy results seen with Grocott-Gomori methenamine-silver stain (GMS) with fungal organisms compatible with Histoplasma capsulatum, however there exists morphologic overlap with Cryptococcus making it difficult to exclude Crytpococcal infection.
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Biopsy results revealed necrotizing granulomatous inflammation with calcification, which is consistent with a histoplasmosis mediastinal granuloma, see Fig. 3.