Archive of Old Cases
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- Archive of Old Cases
- 2013
Case No : 831 Date 2013-09-30
- Courtesy of Kun Young Lim, Hyae Young Kim, Soo Hyun Lee / National Cancer Center, Korea
- Age/Sex 58 / M
- Chief ComplaintS/P total gastrectomy due to early gastric cancer. Routine postop follow up
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Pulmonary cryptococcosis
- Radiologic Findings
- Fig. 1
Chest radiograph shows multiple ill defined nodules in the right lung.
Fig. 2, 3
Chest CT scans show multiple nodules, one of which is cavitated, in the right lung.
Bronchoscopic biopsy at the right middle lobe revealed chronic granulomatous inflammation with many yeast-form fungal organisms, consistent with cryptococcosis.
- Brief Review
- Cryptococcus neoformans is a ubiquitous encapsulated yeast like fungus and inhalation is the usual portal of entry of infection. The organism may cause isolated pulmonary infection or may progress to disseminated disease, particularly in immunocompromised patients. Pulmonary cryptococcosis in the immunocompetent host is rare and may be asymptomatic.
The most common radiologic finding of pulmonary cryptococcosis is single or multiple pulmonary nodules. Segmental or lobar consolidation, ground glass opacities and a reticulonodular pattern of opacities are also recognized features. Miliary disease, cavitation, pleural effusions, and lymphadenopathy are seen more frequently in immunocompromised patients. - References
- 1.Lindell RM, Hartman TE, Nadrous HF, et al. Pulmonary Cryptococcosis: CT Findings in Immunocompetent Patients. Radiology 2005;236:326
2. Fox DL, Muller NL. Pulmonary cryptococcosis in immunocompetent patients: CT findings in 12 patients. AJR Am J Roentgenol 2005;185:622-626
3.Chang W, Tzao C, Hsu H, et al. Pulmonary Cryptococcosis: Comparison of Clinical and Radiographic Characteristics in Immunocompetent and Immunocompromised Patients. CHEST 2006;129:333
4. Song KD, Lee KS, Chung MP et al. Pulmonary Cryptococcosis: Imaging Findings in 23 Non-AIDS Patients. Korean J Radiol 2010;11:407-416 - Keywords
- Lung, infection, Fungal infection,
No. of Applicants : 66
- ▶ Correct Answer : 10/66, 15.2%
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- - SNUH , Korea (South) Eui Jin Hwang
- - Niigata City General Hospital , Japan Takao Kiguchi
- - Kyung Hee University Hospital at Gangdong , Korea (South) Seong Jong Yun
- - the First Affiliated Hospital of NanJing Medical University , China Aiping Chen
- - Onomichi municipal hospital , Japan Hirofumi Mifune
- - Myongji hospital , Korea (South) Ji Ye Lee
- - Chonbuk University Hospital , Korea (South) Sungkwan Kim
- - CAC Rennes , France nicolas gautier
- - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
- - Kyungpook National University Hospital , Korea (South) Jaekwang Lim
- ▶ Correct Answer as Differential Diagnosis : 17/66, 25.8%
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- - Scans world , India Philson Mukkada
- - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
- - stanley medical college , India yazhini v
- - CHU Poitiers , France CHAN paul
- - Niigata University , Japan Atsushi Uehara
- - MBAL Chernomorska , Bulgaria VLADISLAV RUSINOV
- - Kyoto University , Japan Akihiko Sakata
- - GHICL , France manuel toledano
- - Nagasaki University Hospital, Department of Pathology , Japan TOMONORI TANAKA
- - ICD,MCH CALICUT , India rikhy krishnan
- - Asan medical center , Korea (South) yoonyoung choi
- - Asan medical center , Korea (South) Hyun Joo Lee
- - Columbia Asia , India John Joseph
- - Shiga University of Medical Science , Japan Akitoshi Inoue
- - Tokyo Metropolitan Police Hospital , Japan Akifumi Hagiwara
- - Kizawa Memorial Hospital , Japan Yo Kaneko
- - CLINIQUE STE CLOTILDE , Reunion patrick MASCAREL
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Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com
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