[A case of lung cancer with cryptococcal infection in resected lymph nodes]

A 68-year-old female was admitted because of an abnormal shadow on chest X-ray film. Chest CT showed a nodular shadow in right S3a. Right upper lobectomy with mediastinal lymph node resection was performed under a diagnosis of lung cancer made by TBLB. Pathological examination of the resected lung revealed well differentiated adenocarcinoma. In addition, examination of the resected lymph nodes showed granulomas, some of which contained numerous cryptococci and showed central caseous necrosis, and others showed non-caseating epithelioid cell granulomas suggesting sarcoid reaction. No cryptococcal infection was found in the resected lung. Mediastinal lymph node involvement of cryptococcus in this case was considered to be the lymph node component of the primary pulmonary complex of cryptococcosis. Such a primary complex was demonstrated in 1% of the cases of cryptococcosis in previous reports.