Hsu Chung-Huei, Lee Chi-Ming, Wang Fong-Chieh, Lin Yun-Ho
PET Center, Taiwan, ROC, USA.
Clin Nucl Med. 2003 Sep;28(9):791-3. doi: 10.1097/01.rlu.0000082680.98898.2b.
Cryptococcosis is not uncommon. Potential interpretation pitfalls should be kept in mind when fluorodeoxyglucose (FDG) positron emission tomography (PET) is used for differentiating pulmonary nodules and for discriminating infection from malignancy, especially in areas where the prevalence of granulomatous infection is high and in immunocompromised patients. In this case, a nodular mass was shown on chest radiography and computed tomographic (CT) scanning. A consolidated infection or a bronchioloalveolar carcinoma was suspected because the CT scan showed air bronchograms within the mass and another perihilar infiltration. The FDG PET scan clearly delineated the lesion and had intermediately high glucose uptake (standard uptake value, 3.8-4.0), which led to the exclusion of the possibility of bronchioloalveolar carcinoma because most of these tumors had normal or mildly increased FDG accumulation. Cryptococcoma was finally diagnosed. Hence, the CT scan and FDG PET played complementary roles in the differential diagnosis of this nodular mass.
隐球菌病并不罕见。当使用氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）来鉴别肺结节以及区分感染与恶性肿瘤时，应牢记潜在的解读陷阱，特别是在肉芽肿性感染患病率较高的地区以及免疫功能低下的患者中。在该病例中，胸部X线摄影和计算机断层扫描（CT）显示有一个结节状肿块。由于CT扫描显示肿块内有空气支气管征以及另一个肺门周围浸润，怀疑是 consolidation 感染或细支气管肺泡癌。FDG PET扫描清晰地勾勒出病变，且葡萄糖摄取呈中等程度增高（标准化摄取值，3.8 - 4.0），这排除了细支气管肺泡癌的可能性，因为这些肿瘤大多数FDG摄取正常或轻度增加。最终诊断为隐球菌瘤。因此，CT扫描和FDG PET在该结节状肿块的鉴别诊断中发挥了互补作用。
原文中“consolidated infection”不太确定准确意思，暂直译为“consolidation感染” ，你可根据准确医学术语进一步调整。
