{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:05:58Z","timestamp":1784534758869,"version":"3.55.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T00:00:00Z","timestamp":1784505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007397","name":"Charles University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Virchows Arch"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cases of tularemia in humans are rare in the Czech Republic, and pulmonary involvement is exceptional; consequently, it is seldom considered in the initial differential diagnosis. We report the case of a patient admitted with complicated pneumonia. Radiological imaging revealed a centrally located mass in the right lung with surrounding extensive pneumonia and regional lymphadenopathy, raising suspicion of lung carcinoma or pneumonia complicated by abscess formation. The patient subsequently underwent lobectomy. Histopathological examination demonstrated a necrotizing granulomatous process, and molecular analysis confirmed infection with Francisella tularensis. Pulmonary tularemia was therefore diagnosed only after surgical resection. Review of the literature reveals that pulmonary tularemia may closely mimic lung cancer or lymphoma on clinical and radiological grounds, frequently resulting in delayed diagnosis. Increased awareness of this rare entity among clinicians and pathologists may facilitate earlier recognition and prevent unnecessary extensive surgical interventions.<\/jats:p>","DOI":"10.1007\/s00428-026-04638-4","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:37:04Z","timestamp":1784533024000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rare pulmonary tularemia masquerading as lung cancer: importance of considering infectious etiologies and a comprehensive literature review"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4424-7174","authenticated-orcid":false,"given":"Krist\u00fdna","family":"Behensk\u00e1","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"N\u011bmcov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom\u00e1\u0161","family":"Malkus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michal","family":"Michal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Bradov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,20]]},"reference":[{"key":"4638_CR1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.26444\/aaem\/139242","volume":"29","author":"M Wawszczak","year":"2022","unstructured":"Wawszczak M, Banaszczak B, Rastawicki W (2022) Tularaemia - a diagnostic challenge. 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Kevin King declares no relevant financial relationships with ineligible companies"},{"key":"4638_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12223-020-00827-z","volume":"66","author":"DK Yeni","year":"2021","unstructured":"Yeni DK, B\u00fcy\u00fck F, Ashraf A et al (2021) Tularemia: a re-emerging tick-borne infectious disease. Folia Microbiol (Praha) 66:1\u201314","journal-title":"Folia Microbiol (Praha)"},{"key":"4638_CR5","doi-asserted-by":"publisher","first-page":"116554","DOI":"10.1016\/j.diagmicrobio.2024.116554","volume":"110","author":"Y K\u0131ymaz","year":"2024","unstructured":"K\u0131ymaz Y, \u00d6zbey M (2024) A case of pulmonary tularemia mimicking lung cancer. Diagn Microbiol Infect Dis 110:116554","journal-title":"Diagn Microbiol Infect Dis"},{"key":"4638_CR6","unstructured":"\u010cR Sz\u00fa V\u00fdskyt vybran\u00fdch hl\u00e1\u0161en\u00fdch infekc\u00ed podle kraj\u016f v \u010cesk\u00e9 republice. 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However, the patient was fully informed about the study and provided verbal consent to participate.","order":2,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"For this type of study consent for publication is not required.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":4,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}]}}