Lan C Q, Weng H, Li H Y, Chen L, Lin Q H, Liu J F, Huang J B
*Department of Radiology, Fuzhou Pulmonary Hospital of Fujian, Teaching Hospital of Fujian Medical University, Fuzhou 350008, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2016 Nov 12;39(11):862-865. doi: 10.3760/cma.j.issn.1001-0939.2016.11.008.
To investigate the clinical features of pulmonary cryptococcosis(PC). A total of 117 cases of PC, confirmed by pathological examinations at Fuzhou Pulmonary Hospital of Fujian from January 2009 to December 2013, were studied. The patients consisted of 75 males and 42 females, with a mean age of (44.1±13.7) years (range, 16 to 76 years). Thirty-eight cases were immunocompromised hosts (ICH) and 79 cases were non-immunocompromised hosts (NICH). The clinical symptoms of most patients were mild and the main clinical manifestations were cough and sputum production. The chest CT manifestations were as follows: nodular or mass-like shadows in 66, patchy infiltrates or consolidation in 34, and mixed lesions in 17 cases. There were a variety of CT signs accompanied, with halo sign (78 cases) and proximal air bronchogram (63 cases) being the most common. These two signs were more common in NICH than ICH (77.2%, 44.7%, =0.001; 60.8%, 39.5%, =0.047). They were also more likely to be seen in the patchy infiltrates or consolidation and mixed patterns than in nodular or mass-like type of PC(82.4%, 82.4% and 54.5%, =0.007; 76.5%, 82.4% and 33.3%, =0.000), while lobulation sign, spicule sign and pleural indentation were more likely to be seen in the latter(0%, 5.9% and 30.3%, =0.000; 0%, 5.9% and 27.3%, =0.000; 0%, 5.9% and 19.7%, =0.005). The lesions of PC were mainly found in the right lung and lower lobes. The lesions in NICH were more commonly seen in multiple lobes than ICH. Enhanced CT scanning was performed in 38 patients, and 24 cases showed uniform enhancement and 27 moderate enhancement. The diagnosis was confirmed in all cases by pathological findings. A hundred and one cases were treated and carefully followed in our hospital except 16 cases who were lost for follow-up. Seventy-one were cured and 30 were improved. The clinical symptoms of PC were diverse and nonspecific. Halo sign and proximal air bronchogram are helpful for the diagnosis of PC. The outcome of most patients was satisfactory after appropriate treatment.
为研究肺隐球菌病（PC）的临床特征。对2009年1月至2013年12月在福建省福州肺科医院经病理检查确诊的117例PC患者进行研究。患者包括75例男性和42例女性，平均年龄为（44.1±13.7）岁（范围16至76岁）。38例为免疫功能低下宿主（ICH），79例为非免疫功能低下宿主（NICH）。大多数患者临床症状较轻，主要临床表现为咳嗽、咳痰。胸部CT表现如下：结节状或肿块样阴影66例，斑片状浸润或实变34例，混合性病变17例。伴有多种CT征象，以晕征（78例）和近端空气支气管征（63例）最为常见。这两种征象在NICH中比在ICH中更常见（77.2%，44.7%，P=0.001；60.8%，39.5%，P=0.047）。它们在斑片状浸润或实变及混合性病变类型的PC中也比在结节状或肿块样类型中更易见到（82.4%，82.4%和54.5%，P=0.007；76.5%，82.4%和33.3%，P=0.000），而分叶征、毛刺征和胸膜凹陷在后者中更易见到（0%，5.9%和30.3%，P=0.000；0%，5.9%和27.3%，P=0.000；0%，5.9%和19.7%，P=0.005）。PC病变主要位于右肺及下叶。NICH中的病变比ICH中更常见于多个肺叶。38例患者进行了CT增强扫描，24例表现为均匀强化，27例表现为中度强化。所有病例均经病理结果确诊。除16例失访外，101例在我院接受治疗并进行了仔细随访。71例治愈，30例好转。PC的临床症状多样且无特异性。晕征和近端空气支气管征有助于PC的诊断。经过适当治疗，大多数患者的预后令人满意。
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