[A report of 12 cases of primary pulmonary cryptococcosis].
OBJECTIVE
The purpose of this study was to analyze the chest CT findings of immunocompetent patients with primary pulmonary cryptococcosis and to evaluate the utility of CT-guided percutaneous biopsy in the diagnosis.


METHODS
Chest CT scans of 12 immunocompetent patients with biopsy-proven primary pulmonary cryptococcosis were analyzed for the number of lesions, morphologic characteristics, distribution of parenchymal abnormalities, and the presence of lymphadenopathy and pleural effusion. Lung specimens were obtained by CT guided percutaneous biopsy (n = 9) and/or surgical resection (n = 7). A pulmonary pathologist reviewed the specimens.


RESULTS
The main manifestations were classified into two patterns. Localized multiple mixed lesions (nodules and/or masses and/or consolidation) were found in 67% (8/12) of the cases, and single nodules were found in 33% (4/12). Associated findings included air bronchograms (n = 9), cavity (n = 2), and CT halo sign (n = 4). Lung specimens were obtained by CT guided percutaneous biopsy in 9 cases, of which 7 (78%) were confirmed by pathology. Seven cases recovered after treatment with fluconazole, but cryptococcal meningitis occurred in 1 case 5 month after single excision.


CONCLUSIONS
Chest CT findings of primary pulmonary cryptococcosis in immunocompetent patients have a predominant pattern of localized multiple mixed lesions. CT guided percutaneous biopsy is helpful in confirming the diagnosis. Fluconazole is effective in the treatment of pulmonary cryptococcosis in these patients.
Hu
Hong-Jie
HJ
Department of Radiology, Sir Run Run Shaw Hospital, College of Medicine Zhejiang University, Hangzhou 310016, China. hongjiehu@zju.edu.cn
Zhou
Pan
P
Hu
Ji-Bo
JB
Deng
Li-ping
LP
Zhang
Shi-zheng
SZ
Ying
Ke-jing
KJ
D001706:Biopsy; D003453:Cryptococcosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008172:Lung Diseases, Fungal / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed