[Lung pathology of cryptococcosis].
To elucidate the relationship between the clinical manifestations and pathologic findings of the lung in patients with cryptococcosis, we reviewed 14 autopsied cases of cryptococcosis. Five patients had pulmonary cryptococcosis and 9 had disseminated cryptococcosis. Patients with pulmonary cryptococcosis showed granulomatous reactions of the lung, such as fibrocaseous cryptococcoma (n = 2), discrete granuloma (n = 2), and granulomatous pneumonia (n = 1). Patients with disseminated cryptococcosis showed intracapillary/interstitial involvement (n = 2), mucoid pneumonia (n = 3), histiocytic pneumonia (n = 1), and granulomatous pneumonia (n = 3). There was a distinct difference between pulmonary cryptococcosis and disseminated cryptococcosis in lung pathology. Intracapillary/interstitial involvement and mucoid pneumonia were fatal because of extensive hematogeneous dissemination to other organs. Hilar lymph node involvement of cryptococcosis was found in all of the nine patients with disseminated cryptococcosis and in one of the five patients with pulmonary cryptococcosis. Pleural involvement of cryptococcosis was found in six of the nine patients with disseminated cryptococcosis. We conclude that the clinical manifestations of cryptococcosis are closely associated with the variety of lung pathology of cryptococcosis. Clinicians should understand the morphologic features to cope with patients with cryptococcosis.
Department of Respiratory Disease, Tokyo National Chest Hospital, Japan.
A
A
Tamura
O
O
Matsubara
A
A
Hebisawa
S
S
Akagawa
H
H
Shishido
A
A
Kurashima
M
M
Mohri
T
T
Katayama
D000328:Adult; D000368:Aged; D003453:Cryptococcosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008168:Lung / Q000473:pathology*; D008172:Lung Diseases, Fungal / Q000473:pathology; D008297:Male; D008875:Middle Aged