Role of narrowband imaging in assessing endobronchial cryptococcosis

Endobronchial cryptococcosis can cause tracheobronchitis with granulomatous changes. In this patient under steroid therapy, bronchoscopic images revealed elevated white patchy lesion on the posterior longitudinal folds of the lower trachea. Bronchoscopy with narrowband imaging (NBI) revealed opaque bronchial subepithelial vessels. Endobronchial biopsy confirmed Cryptococcus neoformans infection in the subepithelial layer. Following treatment with fluconazole, bronchoscopy with NBI revealed the disappearance of elevated lesion and regrowth of vessels of regular caliber. NBI might be useful to assess and follow-up endobronchial fungal infection and other inflammatory processes.