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肺隐球菌病合并肺腺癌:一例报告并文献复习

Pulmonary cryptococcosis coexisting with lung adenocarcinoma: A case report and review of the literature.

作者信息

Wang Hansheng, Chen Xiao, Wang Yunyun, Yu Dan, Zhou Yanhui, Liu Yan, Tang Yijun, Wang Meifang

机构信息

Department of Pulmonary and Critical Care Medicine, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China.

Department of Laboratory, Shiyan Maternal and Child Health Hospital, Hubei University of Medicine, Shiyan, Hubei 442000, P.R. China.

出版信息

Oncol Lett. 2023 Dec 7;27(2):47. doi: 10.3892/ol.2023.14179. eCollection 2024 Feb.

Abstract

Pulmonary cryptococcosis (PC) is an invasive pulmonary fungal disease caused by or It often presents as a single nodule or mass on radiology, which is easily misdiagnosed as lung cancer or metastases. However, cases of PC coexisting with lung cancer are rare and when this scenario is encountered in clinical practice, it is easy to be misdiagnosed as metastatic lung cancer. The present study reported the case of a 65-year-old immunocompetent patient with PC coexisting with lung adenocarcinoma. Percutaneous lung biopsy was performed on the nodule in the anterior segment of the left upper lobe and the nodule in the posterior basal segment of the left lower lobe, which were diagnosed as primary adenocarcinoma and cryptococcus, respectively. Lung cancer was treated by surgery and PC was treated successfully by antifungal treatment. During the 5-year follow-up, contrast-enhanced CT showed no recurrence of either disease. This case reminds us of the possibility of dualism in the diagnosis of multiple pulmonary nodules based on CT examination, such as the coexistence of lung carcinoma and PC. In addition, early diagnosis and treatment contribute to good prognosis.

摘要

肺隐球菌病(PC)是一种由新型隐球菌引起的侵袭性肺部真菌病。它在影像学上常表现为单个结节或肿块,容易被误诊为肺癌或转移瘤。然而,PC与肺癌共存的病例罕见,在临床实践中遇到这种情况时,很容易被误诊为肺转移癌。本研究报告了一例65岁免疫功能正常的患者,其PC与肺腺癌共存。对左上叶前段结节及左下叶后基底段结节进行了经皮肺穿刺活检,分别诊断为原发性腺癌和隐球菌。肺癌通过手术治疗,PC通过抗真菌治疗成功治愈。在5年的随访中,增强CT显示两种疾病均无复发。该病例提醒我们,基于CT检查诊断多个肺结节时存在二元论的可能性,如肺癌与PC共存。此外,早期诊断和治疗有助于良好的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc21/10722552/8c72081a4d02/ol-27-02-14179-g00.jpg

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