title: Case of pulmonary cryptococcosis mimicking hematogeneous metastases in an immunocompetent patient: value of absent 18F-fluorodeoxyglucose uptake on positron emission tomography/CT scan.
abstract: The radiologic appearance of multiple discrete pulmonary nodules in immunocompetent patients, with cryptococcal infection, has been rarely described. We describe a case of pulmonary cryptococcosis, presenting with bilaterally and randomly distributed nodules on a computed tomography, mimicking hematogeneous metastases. Positron emission tomography does not demonstrate 18F-fluorodeoxyglucose (FDG) uptake, suggesting a low probability for malignancy, which is a crucial piece of information for clinicians when making a management decision. We find the absence of FDG uptake correlates with the pathologic finding of an infectious nodule, composed of fibrosis and necrosis.
authors.affiliation: Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei 114, Taiwan, Republic of China.
authors.forename: Chiao-Hua
authors.initials: CH
authors.lastname: Lee
authors.forename: Ching
authors.initials: C
authors.lastname: Tzao
authors.forename: Tsun-Hou
authors.initials: TH
authors.lastname: Chang
authors.forename: Wei-Chou
authors.initials: WC
authors.lastname: Chang
authors.forename: Guo-Shu
authors.initials: GS
authors.lastname: Huang
authors.forename: Chih-Kung
authors.initials: CK
authors.lastname: Lin
authors.forename: Hsin-Chung
authors.initials: HC
authors.lastname: Lin
authors.forename: Hsian-He
authors.initials: HH
authors.lastname: Hsu
mesh_terms: D003453:Cryptococcosis / Q000000981:diagnostic imaging* / Q000378:metabolism; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D007121:Immunocompetence; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging* / Q000378:metabolism; D008175:Lung Neoplasms / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D055613:Multiple Pulmonary Nodules / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Cryptococcosis; Multiple pulmonary nodules; Neoplasm metastasis; Positron emission tomography