title: Pulmonary cryptococcosis in rheumatoid arthritis (RA) patients: comparison of imaging characteristics among RA, acquired immunodeficiency syndrome, and immunocompetent patients.
abstract: OBJECTIVE
  The imaging characteristics of cryptococcosis in rheumatoid arthritis (RA) patients were analyzed by comparing them with those of acquired immunodeficiency syndrome (AIDS) and immunocompetent patients, and the imaging findings were correlated with pathological findings.
  
  
  METHODS
  Two radiologists retrospectively compared the computed tomographic (CT) findings of 35 episodes of pulmonary cryptococcosis in 31 patients with 3 kinds of underlying states (10 RA, 12 AIDS, 13 immunocompetent), focusing on the nature, number, and distribution of lesions. The pathological findings of 18 patients (8 RA, 2 AIDS, 8 immunocompetent) were analyzed by two pathologists, and then correlated with imaging findings.
  
  
  RESULTS
  The frequencies of consolidation and ground glass attenuation (GGA) were significantly higher, and the frequency of peripheral distribution was significantly lower in the RA group than in the immunocompetent group. Peripheral distribution was less common and generalized distribution was more frequent in the RA group than in the AIDS group. The pathological findings of the AIDS and immunocompetent groups reflected their immune status: There was lack of a granuloma reaction in the AIDS group, and a complete granuloma reaction in the immunocompetent group, while the findings of the RA group varied, including a complete granuloma reaction, a loose granuloma reaction and a hyper-immune reaction. Cases with the last two pathologic findings were symptomatic and showed generalized or central distribution on CT.
  
  
  CONCLUSIONS
  Cryptococcosis in the RA group showed characteristic radiological and pathological findings compared with the other 2 groups.
authors: Departments of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-8-22, Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan. Electronic address: noriyo_yana@ybb.ne.jp.
authors: Noriyo
authors: N
authors: Yanagawa
authors: Fumikazu
authors: F
authors: Sakai
authors: Tamiko
authors: T
authors: Takemura
authors: Satoru
authors: S
authors: Ishikawa
authors: Yasunobu
authors: Y
authors: Takaki
authors: Tsunekazu
authors: T
authors: Hishima
authors: Noriko
authors: N
authors: Kamata
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D003453:Cryptococcosis / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007121:Immunocompetence / Q000276:immunology; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: Computed tomography; Pulmonary cryptococcosis; Rheumatoid arthritis