Nishii K, Kodani T, Uji H, Moritani Y, Ohnoshi T, Hiraki S, Ueoka H, Numata T, Maeda T, Kimura I
Antituberuculosis Association, Okayama Branch, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Sep;30(9):1662-6.
Six patients with asymptomatic primary pulmonary Cryptococcosis are reported. In all of the patients, the disease was detected by annual chest X-ray during mass screening for lung cancer or during follow-up for pulmonary tuberculosis or gastric cancer. The chest X-ray findings consisted of a solitary pulmonary nodule in 4 patients and multiple pulmonary nodules in 2. Only one patient who could not be histologically diagnosed by bronchofiberscopy underwent surgical resection. However, the other 5 patients were histologically diagnosed by transbronchial biopsy with bronchofiberscopy. They were treated with oral antifungal agents, namely flucytosine (5-FC) and/or fluconazole, with marked improvement of chest X-ray findings. These results indicate that transbronchial biopsy with bronchofiberscopy and oral administration of antifungal agents instead of initial surgical resection are useful in the diagnosis and treatment of primary pulmonary cryptococcosis.
报告了6例无症状原发性肺隐球菌病患者。所有患者均在肺癌大规模筛查期间或肺结核或胃癌随访期间通过年度胸部X线检查发现该病。胸部X线表现为4例患者为孤立性肺结节，2例为多发性肺结节。只有1例经支气管纤维镜检查不能进行组织学诊断的患者接受了手术切除。然而，其他5例患者通过支气管纤维镜经支气管活检进行了组织学诊断。他们接受了口服抗真菌药物治疗，即氟胞嘧啶（5-FC）和/或氟康唑，胸部X线表现有明显改善。这些结果表明，支气管纤维镜经支气管活检和口服抗真菌药物而非初始手术切除对原发性肺隐球菌病的诊断和治疗是有用的。
