title: Disseminated cryptococcosis with pulmonary and marrow involvement mimicking radiological features of malignancy.
abstract: 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.
authors.affiliation: Department of Diagnostic Radiology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, ROC.
authors.forename: Cheng-Tau
authors.initials: CT
authors.lastname: Su
authors.forename: Liang-Kuang
authors.initials: LK
authors.lastname: Chen
authors.forename: Yuh-Feng
authors.initials: YF
authors.lastname: Tsai
authors.forename: Chu-Jen
authors.initials: CJ
authors.lastname: Kuo
authors.forename: Chien-Li
authors.initials: CL
authors.lastname: Lu
authors.forename: Hsu-Yi
authors.initials: HY
authors.lastname: Chen
mesh_terms: 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