Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Pulmonary cryptococcosis
- Radiologic Findings
- Chest radiograph shows consolidation in right upper, lower lung zone and small nodule in left lower lung zone.
Contrast-enhanced chest CT images demonstrate peripheral consolidation with internal low density in right upper and middle lobe. Several irregular nodules or cavities are noted in both lungs. There are multiple enhancing lymph nodes in mediastinum and bilateral pleural effusion.
The patient underwent CT-guided transthoracic core-needle biopsy. Pathologic specimen revealed chronic granulomatous inflammation with numerous fungal yeasts, which were consistent with cryptococcosis.
- Brief Review
- Pulmonary cryptococcosis is caused by fungal group of Cryptococcus species (m/c: C. neoformans) which are ubiquitous encapsulated yeasts found worldwide. The infection usually affects immunocompromised patients, particularly those with an impaired cell-mediated immune response. Most immunocompetent individuals have mild or no clinical symptoms with isolated pulmonary involvement, otherwise more aggressive clinical and radiographic findings in immunocompetent patients.
Pulmonary cryptococcal infection has a variety of manifestations from lung nodules to mass-like appearance. The most common radiographic manifestations of pulmonary cryptococcosis consist of single or multiple pulmonary nodules, segmental or lobar consolidation or a reticulonodular pattern of opacities. Associated features include cavitation, lymphadenopathy and pleural effusion.
- Please refer to
Case 181, Case 231, Case 247, Case 282, Case 305, Case 346, Case 368, Case 388, Case 446, Case 484, Case 512, Case 603, Case 632, Case 671, Case 754, Case 770, Case 817, Case 831, Case 842, Case 862, Case 891, Case 923, Case 945, Case 964, Case 987, Case 1046, -
KSTR Imaging Conference 2001 Spring Case 6
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Thoracic Imaging 2003- Korean & Japanese Film Interpretation - Case 5
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KSTR Imaging conference 2009 Summer Case 16,
- References
- 1. SUWATANAPONGCHED, Thitiporn, et al. Clinical and radiologic manifestations of pulmonary cryptococcosis in immunocompetent patients and their outcomes after treatment. Diagnostic and Interventional Radiology, 2013, 19.6: 438.
2. THAMBIDURAI, Lasya, et al. Cryptococcal pneumonia: the great mimicker. BJR| case reports, 2017, 20150358.
- Keywords
- lung, fungal infection, cryptococcosis,