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[A clinicopathological study of pulmonary cryptococcosis--chest CT and pathologic correlation]
1Division of Respiratory Diseases, Toranomon Hospital, Tokyo, Japan.
Summary
Pulmonary cryptococcosis often presents as asymptomatic nodules on chest imaging, mimicking lung cancer or tuberculosis. Pathological examination is crucial for accurate diagnosis and to prevent misdiagnosis.
Area of Science:
- Pulmonology
- Infectious Diseases
- Radiology
Background:
- Pulmonary cryptococcosis is a fungal infection that can present with varied radiologic findings.
- Distinguishing it from other pulmonary conditions like lung cancer and tuberculosis can be challenging based solely on imaging.
Purpose of the Study:
- To review the clinicopathological features of pulmonary cryptococcosis.
- To highlight imaging characteristics and diagnostic challenges.
Main Methods:
- Retrospective review of 12 patients diagnosed with pulmonary cryptococcosis.
- Analysis of clinicopathological data, chest radiographs, and chest CT scans.
- Correlation with pathological findings based on McDonnell's classification.
Main Results:
- Eleven of 12 patients were asymptomatic, with disease detected incidentally on chest radiographs.
- Chest CT scans predominantly showed solitary, subpleural nodules (<2 cm).
- Imaging features like cavitary or spiculated nodules posed diagnostic challenges, mimicking tuberculosis or lung cancer.
Conclusions:
- Pulmonary cryptococcosis frequently presents as asymptomatic pulmonary nodules.
- Radiological findings can overlap with lung cancer and tuberculosis, necessitating pathological examination for definitive diagnosis.
- Pathological examination is essential to avoid misdiagnosis and ensure appropriate management.