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Weekly Chest CasesArchive of Old Cases

Case No : 987 Date 2016-09-26

  • Courtesy of Dae-Wook Yeh / Busan Paik Hospital
  • Age/Sex 55 / M
  • Chief ComplaintCough for two weeks. The patient had a history of diabetes.
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Diagnosis With Brief Discussion

Diagnosis
Pulmonary cryptococcosis
Radiologic Findings
Chest radiograph shows a nodular opacity in left lower lung zone.
Contrast-enhanced chest CT images demonstrate 16mm solid nodule with two small nodules in RUL, and 17mm nodule with other smaller nodules in LLL.
The patient underwent CT-guided transthoracic core-needle biopsy. Pathologic specimen revealed many spore-form organisms in cytoplasm of multinucleated giant cells of alveolar space, which were morphologically consistent with cryptococci.
Brief Review
The most common CT finding of pulmonary cryptococcosis in immunocompetent host is single or multiple pulmonary nodules or masses, which are located predominantly in peripheral lung. be Cavitating nodules and cavitating consolidation may be present in 10% to 42% of the patients. . Less common findings include consolidation, ground-glass opacity, and mild interlobular septal thickening. Lymphadenopathy is reported in 17% to 20%. Pleural effusion is uncommon.
References
1.Fox DL, Muller NL. Pulmonary cryptococcosis in immunocompetent patients: CT findings in 12 patients. AJR Am J Roentgenol 2005;185(3):622–626.
2.Lindell RM, Hartman TE, Nadrous HF, et al. Pulmonary cryptococcosis: CT findings in immunocompetent patients. Radiology 2005;236(1):326–331.
Please refer to
Case 388 Case 842 Case 945
Keywords
Lung, Infection, Fungal infection,

No. of Applicants : 99

▶ Correct Answer : 57/99,  57.6%
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
  • - Otsu Municipal Hospital , Japan Noriatsu Ichiba
  • - Osaka Rosai Hospital , Japan Hiromitsu Sumikawa
  • - ZIGONG TCM HOSPITAL OF CHINA , China Cao Cunyou
  • - Kizawa Memorial Hospital , Japan Tomohiro Ando
  • - Shanghai Jiao Tong University Affiliated Sixth People萸 , China Jiayin Zhang
  • - , Korea (South)
  • - Ajou university hospital , Korea (South) Pae Sun Suh
  • - The University of Tokyo Hospital , Japan Yusuke Watanabe
  • - Ajou university hospital , Korea (South) DONGHYUN LEE
  • - chungbuk national university hospital , Korea (South) soojung lee
  • - Nasaret Hospital , Korea (South) Hee Seok Choi
  • - Asan Medical Center , Korea (South) Hyung Jung Koo
  • - Korea university Guro hospital , Korea (South) Hyun Ji Lee
  • - The first affiliated Hospital of Xiamen University , China Qing Qiang Guo
  • - , Korea (South) BAEK YOOLIM
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Ajou University Hospital , Korea (South) Taeyang Ha
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - Department of Radiology, Seoul National University Bundang Hospital , Korea (South) Sung Hyun Yoon
  • - 異⑸ , Korea (South) 蹂€
  • - Gifu University Hospital , Japan Yo Kaneko
  • - SNUH , Korea (South) TAE HYUNG KIM
  • - Inje University Haeundae Paik Hospital , Korea (South) Kyungwon Doo
  • - Chungbuk national university , Korea (South) Yong Kim
  • - Medicheck health care , Korea (South) Chae Lim
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Han Na Lee
  • - chungbuk national university hospital , Korea (South) lee jung hwan
  • - Okayama University Hospital , Japan Toshiyuki Komaki
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Samsung Medical Center , Korea (South) Boda Nam
  • - Chungbuk national university hospital , Korea (South) Miran Yeon
  • - Azienda Ospedaliera di Cremona , Italy Pietro Sergio
  • - Seoul national university hospital , Korea (South) Kumju Chae
  • - Asan Medical Center , Korea (South) Chan Ho Park
  • - Red Cross Society Himeji Hospital , Japan Soichiro Okamoto
  • - Ajou University Hospital , Korea (South) Young Keun Sur
  • - Aerospace medical group, Air Force Education and Training Command , Korea (South) Donghwan Kim
  • - Korea university medical center, guro hospital , Korea (South) LEE CHONG
  • - Maternity & child hospital , Saudi Arabia Sania ALBlushi
  • - Korea university medical center, guro hospital , Korea (South) JINWOO HAN
  • - Ajou University Hospital , Korea (South) Seulgi You
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - The University of Tokyo Hospital , Japan Kaoru Sumida
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Jangsung public clinic , Korea (South) Yongsub Song
  • - University of Tsukuba , Japan Toshitaka Ishiguro
  • - Korea University Guro Hospital , Korea (South) Jeong Woo Kim
  • - Private sector , Greece Vasilios Tzilas
  • - SNUH , Korea (South) Juil Park
  • - Kyoto University , Japan Akihiko Sakata
  • - the first affiliatited hospital of nanjing medical univercity , China Hai Xu
  • - 異⑸ , Korea (South) 瑜˜
  • - Korea University Guro Hospital , Korea (South) Hwanseok Yong
  • - Ajou University Hospital , Korea (South) Youngjin Yoo
▶ Correct Answer as Differential Diagnosis : 18/99,  18.2%
  • - Saitama-Sekishinkai Hosptal , Japan Mihoko Yamazaki
  • - Northern Yokohama Showa university , Japan Kota Watanabe
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - thiruvarur medical college , India arivudai nambi
  • - IRSA LA ROCHELLE , France, Metropolitan BIGOT
  • - Kashan University of Medical Sciences, kashan , Iran Ebrahim Razi
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - The Jikei university , Japan Taku Gomi
  • - Seoul National University Hospital , Korea (South) Hyoung-In Choi
  • - Narayana Multispeciality Hospital Jaipur Raj , India JAINENDRA JAIN
  • - Mallinckrodt Institute of Radiology , United States Naganathan Mani
  • - University of Tsukuba, Dept of Radiology , Japan Manabu Minami
  • - CHU Poitiers , France CHAN paul
  • - NASA SCANS , India RAKESH BHATIA
  • - sunder lal jain hospital , India sanjeev vachher
  • - Seoul National University Hospital , Korea (South) Sunkyung Jeon
  • - Diagnose.me (BV) / Royal Perth Hospital , Australia Yuranga Weerakkody
▶ Semi-Correct Answer : 12/99,  12.1%
  • - University of ottawa , Canada Subramaniyah Ramanathan
  • - radiologist, aditya imaging centre , India vivek patel
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Kyungpook national university , Korea (South) Chungeun Lim
  • - Seoul National University Bundang Hospital , Korea (South) Ji Eun Park
  • - �stanbul , Turkey Ayhan Yilmaz
  • - university of montreal , Canada Andrei Gorgos I
  • - University of Tsukuba Hospital , Japan Hiroaki Takahashi
  • - Avrasya Hospital , Turkey Murat Ulusoy
  • - Max Hospital New Delhi , India Rajesh Gothi
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - MBAL BURGAS , Bulgaria VLADISLAV RUSINOV
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