Kobayashi Misato, Tsubata Yukari, Shiratsuki Yohei, Hotta Takamasa, Isobe Takeshi
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of medicine, Izumo, JPN.
Department of Internal Medicine, Division of Medical Oncology & Respiratory Medicine, Shimane University Faculty of Medicine, Izumo, JPN.
Cureus. 2022 Jan 25;14(1):e21590. doi: 10.7759/cureus.21590. eCollection 2022 Jan.
We encountered a case of pneumocystis pneumonia (PCP) presenting with multiple mass lesions in a human immunodeficiency virus (HIV)-negative patient. Diagnosis of PCP before bronchoscopy was difficult because chest computed tomography (CT) findings were atypical of PCP and a serum (1,3)-β-D-glucan concentration was within normal limits. Bronchoscopic biopsy and Grocott's staining enabled the diagnosis of PCP. PCP can show various patterns on chest CT images, depending on the immune status of the host. In high-risk patients, such as those who are immunocompromised, bronchoscopy should be performed with suspected cases of PCP, even if CT imaging does not show typical ground-glass opacity.
我们遇到了一例肺孢子菌肺炎(PCP),该病例出现在一名人类免疫缺陷病毒(HIV)阴性患者中,表现为多个块状病变。在进行支气管镜检查之前,PCP的诊断很困难,因为胸部计算机断层扫描(CT)结果并非PCP的典型表现,且血清(1,3)-β-D-葡聚糖浓度在正常范围内。支气管镜活检及格罗特染色确诊了PCP。根据宿主的免疫状态,PCP在胸部CT图像上可呈现出多种表现形式。在高危患者中,如免疫功能低下者,即使CT成像未显示典型的磨玻璃影,对于疑似PCP病例也应进行支气管镜检查。