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