Kaplan M H, Rosen P P, Armstrong D
Cancer. 1977 May;39(5):2265-74. doi: 10.1002/1097-0142(197705)39:5<2265::aid-cncr2820390546>3.0.co;2-x.
The clinical and pathological findings in 46 patients with cryptococcosis at Memorial Sloan-Kettering Cancer Center from 1956 to 1972 are reported. The striking predilection for cryptococcal infection in patients with leukemias and lymphomas is again confirmed. Of 41 patients with neoplastic disease, those with chronic lymphatic leukemia (CLL), Hodgkin's Disease, chronic myelogenous leukemia (CML), myeloma and lymphosarcoma had the highest incidence of cryptococcosis. In all cases, neoplastic disease was widespread when infection occurred. All of these patients had leukopenia and absolute lymphopenia at the time of infection. Thirty-nine were on steroids. Thirty-one patients with neoplastic disease had disseminated infection. Review of pathology revealed a spectrum of inflammatory lesions. Histiocytic-lymphocytic infiltrates occurred in the central nervous system in 10 patients. In six cases, reaction was granulomatous. There were single instances of suppurative and fibrotic reactions. Mortality from infection was high in patients with neoplastic disease. Twenty-four of 28 deaths occurred within 60 days as a result of infection. Within one year, 10 more patients died, nine of cryptococcosis. Only three survived more than one year, and all patients died within 600 days. Twenty-nine patients with neoplastic disease received amphotericin B. Only nine survived more than 60 days.
报告了1956年至1972年在纪念斯隆-凯特琳癌症中心46例隐球菌病患者的临床和病理结果。再次证实白血病和淋巴瘤患者对隐球菌感染有明显的易感性。在41例患有肿瘤疾病的患者中，慢性淋巴细胞白血病（CLL）、霍奇金病、慢性粒细胞白血病（CML）、骨髓瘤和淋巴肉瘤患者隐球菌病的发病率最高。在所有病例中，感染发生时肿瘤疾病已广泛播散。所有这些患者在感染时均有白细胞减少和绝对淋巴细胞减少。39例正在使用类固醇。31例患有肿瘤疾病的患者发生了播散性感染。病理检查显示有一系列炎症病变。10例患者中枢神经系统出现组织细胞-淋巴细胞浸润。6例为肉芽肿反应。有单个化脓性和纤维化反应的病例。肿瘤疾病患者的感染死亡率很高。28例死亡患者中有24例在60天内因感染死亡。在一年内，又有10例患者死亡，其中9例死于隐球菌病。只有3例存活超过一年，所有患者均在600天内死亡。29例患有肿瘤疾病的患者接受了两性霉素B治疗。只有9例存活超过60天。
