不同免疫状态下渗出性肺隐球菌病的临床影像学多样性

Clinical-imaging diversity of exudative pulmonary cryptococcosis with different immune states.

作者信息

Zhang Yan-Li, Liu Ling, Li Wei, Ran Chao

机构信息

Department of Clinical Pharmacy, Affiliated Hospital of Yangzhou University, Yangzhou University, No. 368, Hanjiang Middle Road, Hanjiang District, Yangzhou, 225100, China.

Obstetrics Department, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.

出版信息

Sci Rep. 2025 Jul 14;15(1):25346. doi: 10.1038/s41598-025-10807-3.

DOI:10.1038/s41598-025-10807-3

PMID:40659736

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12259976/

Abstract

We aimed to evaluate the clinical-imaging diversity of exudative pulmonary cryptococcosis (PC) with different immune states. The clinical and imaging data of 76 patients with PC (immunocompetent exudative PC 36 cases and immunocompromised exudative PC 40 cases) were respectively reviewed to determine the diagnostic features. Immunocompromised exudative PC was more often with bilateral distribution (30.6% vs. 80.0%, P < 0.001), ground-glass reticular pattern (13.9% vs. 52.5%, P < 0.001), mediastinal lymphadenopathy (0 vs. 20.0%, P = 0.014) and pleural effusion (0 vs. 22.5%, P = 0.007). The inflammatory response (66.7% vs. 20.0%, P < 0.001) and perifissural consolidation (52.8% vs. 12.5%, P < 0.001) were more common in immunocompetent exudative PC. The exudative PC had diverse clinical and imaging findings under different immune states. Inflammatory response, perifissural consolidation, bilateral distribution, ground-glass reticular pattern, mediastinal lymphadenopathy, and pleural effusion could suggest exudative PC with different immune states and provide reliable evidence for clinical diagnosis and treatment.

摘要

我们旨在评估不同免疫状态下渗出性肺隐球菌病（PC）的临床-影像学差异。分别回顾了76例PC患者（免疫功能正常的渗出性PC患者36例，免疫功能低下的渗出性PC患者40例）的临床和影像学资料，以确定诊断特征。免疫功能低下的渗出性PC更常表现为双侧分布（30.6%对80.0%，P<0.001）、磨玻璃网状影（13.9%对52.5%，P<0.001）、纵隔淋巴结肿大（0对20.0%，P=0.014）和胸腔积液（0对22.5%，P=0.007）。炎症反应（66.7%对20.0%，P<0.001）和叶间裂周围实变（52.8%对12.5%，P<0.001）在免疫功能正常的渗出性PC中更常见。不同免疫状态下的渗出性PC具有多样的临床和影像学表现。炎症反应、叶间裂周围实变、双侧分布、磨玻璃网状影、纵隔淋巴结肿大和胸腔积液可提示不同免疫状态的渗出性PC，并为临床诊断和治疗提供可靠依据。