title: A case of multiple pleural cryptococcosis without pleural effusion.
abstract: Pulmonary cryptococcosis is most likely to occur in immunocompromised patients. The radiological manifestations generally include pulmonary parenchymal lesions, namely, pulmonary nodules, cavitary lesions, and consolidation; thus, multiple pleural nodules are unusual presentation. Here, we report a woman who presented with multiple pleural cryptococcosis without pleural effusion. The patient had previously undergone surgery for stage II rectal cancer. In addition, she received 6 cycles of chemotherapy for follicular lymphoma. Computed tomography (CT) revealed multiple small nodules involving the pleura without pleural effusion, which suggested possible recurrence of rectal cancer or malignant lymphoma as pleural dissemination. Thoracoscopic examination was performed, and pleural cryptococcosis was diagnosed. Although pleural cryptococcosis without pleural effusion is extremely rare presentation, clinicians should consider it when an immunocompromised patient presents with multiple pleural nodules. Thoracoscopic exploration should be the best procedure for the definitive diagnosis of multiple pleural nodules.
authors.affiliation: 1 Division of Thoracic Surgery, Department of Surgery, Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan ; 2 Department of Thoracic Surgery, Kyoto University School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan ; 3 Department of Pathology, Kanmon Medical Center, 1-1 Chofusotouracho, Shimonoseki, Yamaguchi 752-8510, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: 1 Division of Thoracic Surgery, Department of Surgery, Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan ; 2 Department of Thoracic Surgery, Kyoto University School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan ; 3 Department of Pathology, Kanmon Medical Center, 1-1 Chofusotouracho, Shimonoseki, Yamaguchi 752-8510, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Takahagi
authors.affiliation: 1 Division of Thoracic Surgery, Department of Surgery, Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan ; 2 Department of Thoracic Surgery, Kyoto University School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan ; 3 Department of Pathology, Kanmon Medical Center, 1-1 Chofusotouracho, Shimonoseki, Yamaguchi 752-8510, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tao
authors.affiliation: 1 Division of Thoracic Surgery, Department of Surgery, Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan ; 2 Department of Thoracic Surgery, Kyoto University School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan ; 3 Department of Pathology, Kanmon Medical Center, 1-1 Chofusotouracho, Shimonoseki, Yamaguchi 752-8510, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: 1 Division of Thoracic Surgery, Department of Surgery, Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan ; 2 Department of Thoracic Surgery, Kyoto University School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan ; 3 Department of Pathology, Kanmon Medical Center, 1-1 Chofusotouracho, Shimonoseki, Yamaguchi 752-8510, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yoshiyama
authors.affiliation: 1 Division of Thoracic Surgery, Department of Surgery, Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan ; 2 Department of Thoracic Surgery, Kyoto University School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan ; 3 Department of Pathology, Kanmon Medical Center, 1-1 Chofusotouracho, Shimonoseki, Yamaguchi 752-8510, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Furukawa
authors.affiliation: 1 Division of Thoracic Surgery, Department of Surgery, Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan ; 2 Department of Thoracic Surgery, Kyoto University School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan ; 3 Department of Pathology, Kanmon Medical Center, 1-1 Chofusotouracho, Shimonoseki, Yamaguchi 752-8510, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Yoshida
authors.affiliation: 1 Division of Thoracic Surgery, Department of Surgery, Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan ; 2 Department of Thoracic Surgery, Kyoto University School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan ; 3 Department of Pathology, Kanmon Medical Center, 1-1 Chofusotouracho, Shimonoseki, Yamaguchi 752-8510, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Murakami
authors.affiliation: 1 Division of Thoracic Surgery, Department of Surgery, Yamaguchi-Ube Medical Center, 685 Higashikiwa, Ube, Yamaguchi 755-0241, Japan ; 2 Department of Thoracic Surgery, Kyoto University School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan ; 3 Department of Pathology, Kanmon Medical Center, 1-1 Chofusotouracho, Shimonoseki, Yamaguchi 752-8510, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Okabe
keywords: Pleural cryptococcosis; thoracoscopic surgery