Oshikawa K, Ohno S, Kitamura S, Sohara Y, Fujii T
Department of Pulmonary Medicine, Jichi Medical School, Tochigi, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Mar;32(3):283-7.
A 68-year-old female was admitted because of an abnormal shadow on chest X-ray film. Chest CT showed a nodular shadow in right S3a. Right upper lobectomy with mediastinal lymph node resection was performed under a diagnosis of lung cancer made by TBLB. Pathological examination of the resected lung revealed well differentiated adenocarcinoma. In addition, examination of the resected lymph nodes showed granulomas, some of which contained numerous cryptococci and showed central caseous necrosis, and others showed non-caseating epithelioid cell granulomas suggesting sarcoid reaction. No cryptococcal infection was found in the resected lung. Mediastinal lymph node involvement of cryptococcus in this case was considered to be the lymph node component of the primary pulmonary complex of cryptococcosis. Such a primary complex was demonstrated in 1% of the cases of cryptococcosis in previous reports.
一名68岁女性因胸部X光片出现异常阴影入院。胸部CT显示右肺上叶S3a有一个结节状阴影。在经支气管肺活检确诊为肺癌后,进行了右上叶切除术及纵隔淋巴结切除术。切除肺组织的病理检查显示为高分化腺癌。此外,切除淋巴结的检查发现肉芽肿,其中一些含有大量隐球菌并呈中央干酪样坏死,另一些则显示非干酪样上皮样细胞肉芽肿,提示结节病反应。在切除的肺组织中未发现隐球菌感染。该病例中纵隔淋巴结隐球菌受累被认为是隐球菌病原发性肺部复合征的淋巴结部分。既往报道中,这种原发性复合征在1%的隐球菌病病例中出现。