Disseminated cryptococcosis with pulmonary and marrow involvement mimicking radiological features of malignancy.
The most commonly involved sites of cryptococcosis are the lungs and the central nervous system. Cryptococcal osteomyelitis is a rare complication of disseminated cryptococcosis, and the vertebraes are the most common site of this infection. The most common underlying disease is sarcoidosis, followed by tuberculosis and previous steroid therapy. Conservative treatment alone or treatment with a combination of the medical and surgical curettage is successful in most cases. We report a case of cryptococcal osteomyelitis in a 63-year-old immunocompetent male who presented with lower back pain over the sacral region for several years. Radiologic studies showed a pulmonary mass and a radiolytic lesion involving the left ischial bone, which mimicked pulmonary malignancy with bone metastasis. Biopsy of the lung mass and the bone lesion revealed abundant cryptococcal organisms, and cryptococcal osteomyelitis was diagnosed.
Su
Cheng-Tau
CT
Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC.
Chen
Liang-Kuang
LK
Tsai
Yuh-Feng
YF
Kuo
Chu-Jen
CJ
Lu
Chien-Li
CL
Chen
Hsu-Yi
HY
D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging*; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D003453:Cryptococcosis / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011859:Radiography