Takenaka Masaru, Hanagiri Takeshi, Oka Sohichi, Baba Tetsuro, Yasuda Manabu, Ono Kenji, Uramoto Hidetaka, So Tomoko, Takenoyama Mitsuhiro, Yamada Sohsuke, Yasumoto Kosei
Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Japan.
J UOEH. 2010 Sep 1;32(3):237-43. doi: 10.7888/juoeh.32.237.
Pulmonary cryptococcosis is a fungal infection caused by inhalation of Cryptococcus neoformans. Pulmonary cryptococcal infections tend to occur in immunocompromised individuals, although they can occasionally develop even in immunocompetent hosts. This report presents a retrospective clinical study of 8 patients who underwent a surgical resection for pulmonary cryptococcosis between 1999 and 2008. The age of the patients ranged from 49 to 85 years old (mean 62.6). There were 4 male and 4 female patients. All patients except for 1 had no symptoms. Two patients were immuno-compromised hosts undergoing corticosteroid therapy due to myasthenia gravis and rheumatoid arthritis, respectively. There were 7 patients with a single nodule and 1 patient with multiple nodules. The tumors ranged from 9 to 21 mm in diameter. None of the patients were definitely diagnosed prior to the surgical resection. The surgical procedures included 5 partial resections, 1 segmentectomy and 2 lobectomies. It is often difficult to make a differential diagnosis between lung cancer and pulmonary cyptococosis, because pulmonary cyptococosis shows similar imaging findings in CT. Therefore, a surgical resection is recommended if an observation of the pulmonary nodes is required to make a differential diagnosis of malignant tumors. All of the patients in the current series showed a good outcome without any relapse including cryptococcal meningitis after a surgical resection.