Xu Li-yu, Liu De-ling, Yu Ying-hao, Wang Tie-zhu, Liu Dao-ming, Lai Guo-xiang
Divison of Pulmonary & Critical Care Medicine, Fuzhou General Hospital of Nanjing Military Command, Fuzhou 350025, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2011 Sep;34(9):653-6.
To investigate the clinical features, radiology, diagnosis and treatment of pulmonary cryptococcosis.
A total of 38 cases of pulmonary cryptococcosis, confirmed by pathological examinations at Fuzhou General Clinical Medical College, Fujian Medical University from March 2003 to February 2010, were retrospectively studied.
All of the cases were community-acquired. The patients consisted of 29 males and 9 females, aged from 21 to 70 years. There were no underlying diseases in 29 cases. The CD(4) cell numbers were normal in 20 patients. Radiological study showed that the majority of the lesions (35 cases) were close to the pleura. Lower lungs were often involved (left 21 and right 23). Pulmonary nodules, either solitary nodules (11 cases) or multiple nodules (16 cases), were the most common CT finding. The lesions had a higher standardized uptake value (SUV) in 4 patients with a PET-CT scan. The lung specimens of 33 cases were obtained by CT guided transthoracic needle aspiration biopsy. The disease was cured in 34 cases, and improved in 3 cases, but 1 died.
Pulmonary cryptococcosis must be considered in the differential diagnosis of lesions of the lungs. The disease has some characteristics on radiology, such as multiple lesions, always close to the pleura and occurs frequently in the lower lungs. CT guided percutaneous biopsy is a safe and effective method for diagnosis.
探讨肺隐球菌病的临床特征、影像学表现、诊断及治疗方法。
回顾性分析福建医科大学附属福州总医院2003年3月至2010年2月期间经病理检查确诊的38例肺隐球菌病患者的临床资料。
所有病例均为社区获得性。患者中男性29例，女性9例，年龄21～70岁。29例患者无基础疾病。20例患者CD(4)细胞数正常。影像学检查显示，多数病灶（35例）靠近胸膜。下肺受累常见（左肺21例，右肺23例）。肺结节是最常见的CT表现，包括孤立结节（11例）和多发结节（16例）。4例行PET-CT检查的患者病灶标准化摄取值（SUV）较高。33例患者经CT引导下经皮肺穿刺活检获取肺组织标本。34例治愈，3例好转，1例死亡。
肺部病变鉴别诊断时须考虑肺隐球菌病。该病在影像学上具有一些特征，如病灶多发、常靠近胸膜且多见于下肺。CT引导下经皮肺穿刺活检是一种安全有效的诊断方法。
