Epithelioid haemangioendothelioma of the lung presenting with pulmonary nocardiosis

Epithelioid haemangioendothelioma of the lung is a rare tumour, originally described as intravascular bronchioalveolar tumour. The typical clinical findings are those of bilateral multiple pulmonary nodules in young or middle aged Caucasian women. Pulmonary nocardiosis is an unusual disease affecting patients with immunodeficiency or chronic obstructive lung disease. The first case of pulmonary epithelioid haemangioendothelioma (PEH) associated with pulmonary nocardiosis, in a 36-year-old woman presenting with progressive dyspnoea and fever, is described. The neoplasm was diagnosed by thoracoscopic lung biopsy and the histological diagnosis was confirmed by immunohistochemistry and electron microscopy. Pulmonary nocardiosis was confirmed by lung tissue culture. Following treatment with antibiotics, the patient's respiratory symptoms subsided. Two years after diagnosis she was asymptomatic and chest CT scans showed stable neoplastic disease.