Feng Chengtao, Zhao Zhihong, Zhao Sheng, Deng Zhiyong, Chen Long
Department of Nuclear Medicine, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, People's Republic of China.
Department of Information, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Peking University Cancer Hospital Yunnan, People's Republic of China.
IDCases. 2025 May 13;40:e02267. doi: 10.1016/j.idcr.2025.e02267. eCollection 2025.
A 55-year-old woman with uncontrolled diabetes presented with a persistent cough and low-grade fever for one month. Initial investigations revealed leukocytosis, elevated CRP, and a 6.1 cm × 5.8 cm mass in the left lung with features suggestive of malignancy on CT and PET/CT scans. However, bronchoscopy and histopathology confirmed a pulmonary fungal infection. The patient was treated with antifungal therapy, showing a favorable response with resolution of symptoms and reduction of the mass size. This case highlights the diagnostic challenges in distinguishing pulmonary fungal infections from malignancies, especially in immunocompromised patients with diabetes. The presence of diabetes contributed to the patient's susceptibility to fungal infections, which mimicked lung cancer on imaging. The importance of maintaining a broad differential diagnosis, including fungal infections, in patients with risk factors and atypical imaging findings is emphasized. Early suspicion and appropriate antifungal therapy are crucial to avoid misdiagnosis and improve outcomes.
一名55岁的糖尿病控制不佳的女性，持续咳嗽和低热1个月。初步检查发现白细胞增多、CRP升高，左肺有一个6.1厘米×5.8厘米的肿块，CT和PET/CT扫描显示有恶性特征。然而，支气管镜检查和组织病理学证实为肺部真菌感染。该患者接受了抗真菌治疗，症状缓解，肿块大小缩小，显示出良好的反应。该病例突出了区分肺部真菌感染与恶性肿瘤的诊断挑战，尤其是在患有糖尿病的免疫功能低下患者中。糖尿病的存在导致患者易患真菌感染，在影像学上酷似肺癌。强调了对于有危险因素和非典型影像学表现的患者保持包括真菌感染在内的广泛鉴别诊断的重要性。早期怀疑和适当的抗真菌治疗对于避免误诊和改善预后至关重要。
