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免疫功能正常患者中酷似肺癌的巨大孤立性肺隐球菌瘤

Large Solitary Pulmonary Cryptococcoma Mimicking Lung Carcinoma in an Immunocompetent Patient.

作者信息

Anandpara Karan Manoj, Aswani Yashant, Hira Priya

机构信息

Department of Radiology Seth G S Medical College and KEM Hospital, Acharya Donde Marg, Parel, Mumbai-400 012 India.

出版信息

Malays J Med Sci. 2018 Feb;25(1):114-118. doi: 10.21315/mjms2018.25.1.13. Epub 2018 Feb 28.

Abstract

Cryptococcosis is a life-threatening mycosis typically seen in immunocompromised patients. Pulmonary cryptococcosis generally presents as multiple or solitary nodular opacities. Cryptococcal infection presenting as a destructing cavernoma (cryptococcoma) without diffuse infiltration of the lung is an extremely rare presentation, even in immunocompromised patients. This report presents a healthy, HIV negative, immunocompetent patient who presented with a large solitary lung mass provisionally diagnosed as a lung malignancy on radiological imaging that proved to be a large cryptococcoma after biopsy. The patient was treated with liposomal Amphotericin B and fluconazole, and the lesion showed regression on serial imaging. This case report thus highlights an unconventional presentation of pulmonary cryptococcosis in an immunocompetent individual.

摘要

隐球菌病是一种危及生命的真菌病,通常见于免疫功能低下的患者。肺隐球菌病一般表现为多发或单发结节状阴影。即使在免疫功能低下的患者中,以破坏性空洞瘤(隐球菌瘤)形式出现而无肺部弥漫性浸润的隐球菌感染也是极其罕见的表现。本报告介绍了一名健康、HIV阴性、免疫功能正常的患者,该患者表现为一个巨大的孤立性肺肿块,影像学检查初步诊断为肺恶性肿瘤,活检后证实为巨大隐球菌瘤。该患者接受了脂质体两性霉素B和氟康唑治疗,病变在系列影像学检查中显示缩小。因此,本病例报告突出了肺隐球菌病在免疫功能正常个体中的非典型表现。

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