title: [Pseudotumoral pulmonary cryptococcosis in association with Cushing's syndrome].
abstract: Opportunistic infections in endogenous Cushing's syndrome are associated with severe cortisol excess and carry a high mortality. Pulmonary cryptococcosis is one of these opportunistic infections and can mimic a lung neoplasm, therefore making its diagnosis difficult. We report a case of a young male with ACTH-dependent Cushing's syndrome and severe hypercortisolism. The patient achieved cure after the transfenoidal surgery, but developed a febrile state. A chest computed tomography showed a pulmonary nodule that did not change in serial chest radiographs. Diagnosis of tuberculosis, fungal and bacterial infections were inconclusive, so the hypothesis of lung neoplasm became more probable. The necropsy, however, disclosed a pseudotumoral cryptococcosis. Opportunistic infections, like Cryptococcus neoformans, should be considered in patients with Cushing's syndrome and a pulmonary infiltrate.
authors.affiliation: Serviços de Endocrinologia, Hospital Universitário Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ. pglaca@yahoo.com
authors.forename: Paulo G S
authors.initials: PG
authors.lastname: Lacativa
authors.forename: Ines
authors.initials: I
authors.lastname: Donangelo
authors.forename: Márcia B
authors.initials: MB
authors.lastname: Wagman
authors.forename: Lino
authors.initials: L
authors.lastname: Sieiro Neto
authors.forename: Carolina R
authors.initials: CR
authors.lastname: Caldas
authors.forename: Alice H D
authors.initials: AH
authors.lastname: Violante
authors.forename: Roberto J
authors.initials: RJ
authors.lastname: Lima
authors.forename: Mário
authors.initials: M
authors.lastname: Vaisman
mesh_terms: D000328:Adult; D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis; D003480:Cushing Syndrome / Q000150:complications*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006801:Humans; D008172:Lung Diseases, Fungal / Q000150:complications* / Q000175:diagnosis; D008175:Lung Neoplasms / Q000175:diagnosis; D008297:Male