Torulema (Toruloma)

Toruloma is a tumor-like formation in the lungs that develops as a result of cryptococcosis.

Cryptococcosis is a fungal disease caused by the yeasts Cryptococcus neoformans and Cryptococcus gattii. These fungi are widespread in the environment and can be inhaled into the lungs by inhaling contaminated air.

In people with weakened immune systems, cryptococcal infection can spread from the lungs to other organs, including the brain, causing cryptococcal meningitis.

One of the manifestations of pulmonary cryptococcosis may be the formation of torulem - tumor-like nodes ranging in size from several millimeters to several centimeters. Histologically, torulemas are granulomas containing cryptococcal fungi and multinucleated giant cells of foreign bodies.

Diagnosis of torulem is based on the detection of Cryptococcus yeast cells by microscopy of sputum smears or lung tissue biopsies. Treatment is carried out with antifungal drugs.

Torulema, also known as cryptococcal pulmonary infiltrate, is a rare post-viral lung lesion resembling a fibrous tumor found in humans, most likely a chronic granulomatosis of a parasitic nature. Taking into account the close etiological relationship between cryptococcal infection and other opportunistic mycoses in people with AIDS, but without HIV infection, the diagnosis of torulem in such patients can be made against the background of prolonged atypical pneumonia with fibrosis of the lung tissue and a recurrent bacterial bronchopulmonary process. Meanwhile, tuberculosis is currently the most common hidden etiological agent of atypical pneumonia in HIV-infected people and persons in sexual contact with them. It is unlikely that cryptococcosis is the triggering factor for such a lesion. In approximately 20% of cases, torules are usually caused by cryptococci present in the lung as a transient cause of the development of pulmonary vascular damage due to the conditions of aspiration of bronchial contents with soil fibrinous opportunistic infiltrate, localized along the peribronchial intervals of the pulmonary fields. Formally, the lung may resemble a cobblestone street or a picture of post-pneumonic pneumofibrosis (the most characteristic type of lesion with cryptococcus); microscopic examination lesions are easily identified as a mass of granulomatous infiltrates around arterioles and venulola. However, characteristic of pulmonary tissue torulem is a constant increase in the level of seacinasm, reflecting a chronic inflammatory process in the lungs. Also specific is the presence of giant cell transformation of macrophages, which serves as the primary diagnostic marker for the identified cryptococcus histologically, at a generally descriptive level.

Toruloma (fungal infection) is a tumor that is morphologically similar to a fungus of the genus Candida or Pichia. However, we are not talking about a fungus, but about one of the conditions of cryptococcosis infection, which consists in the formation of pseudohyphae (vegetative forms of fungi). They grow under the epidermis of the lungs and