Asymptomatic pulmonary nodules in a patient with early-stage breast cancer: Cryptococcus infection

Hsu, Kuo-Feng; Cheng, Yeung-Leung; Hsu, Giu-Cheng; Hsu, Huan-Ming; Yu, Jyh‐Cherng

doi:10.1016/j.ijid.2009.03.007

Cited by 14 publications

(10 citation statements)

References 15 publications

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“…Further longitudinal study is required to understand the development of this form of aspergillosis. Other fungal differential diagnoses for pulmonary nodules in nonimmunocompromised patients include coccidioidomycosis 39 and cryptococcosis 40 …”

Section: Resultsmentioning

confidence: 99%

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Multifocal pulmonary aspergillomas: case series and review

Pendleton

Denning

2012

Annals of the New York Academy of Sciences

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Multifocal lung parenchymal cavities containing multiple aspergillomas are not well-recognized features of chronic pulmonary aspergillosis (CPA). We identified five patients with multiple cavities containing fungal balls from our accumulated cohort of ∼300 patients with CPA. Corticosteroid exposure and radiological and serological characteristics were assessed. The patients, aged 19-55 years, developed 3-11 cavities (or nodules in one case) with thin walls, usually within the lung parenchyma, with very limited pleural involvement. Four had asthma (severe in three) and one had cystic fibrosis; three had allergic bronchopulmonary aspergillosis. All patients had received corticosteroids orally or by inhalation. Four patients had elevated Aspergillus IgG antibodies; one had elevated Aspergillus-specific IgE. Three patients developed azole resistance on antifungal therapy, after benefit, one of whom underwent a successful bilateral lung transplant, later complicated by a fatal mycotic cerebral aneurysm. Multiple aspergillomas is a new distinct manifestation of CPA. The lack of inflammatory response and the distribution of the cavities in the lungs are remarkable. Aspergillus nodules could evolve into cavities with aspergillomas. The management and development of azole resistance in these patients is problematic.

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Section: Resultsmentioning

confidence: 99%

“…Other fungal differential diagnoses for pulmonary nodules in nonimmunocompromised patients include coccidioidomycosis 39 and cryptococcosis. 40 Aspergillus precipitins (IgG antibody) are detectable in over 95% of patients with aspergilloma. 41 About 40% of patients are sensitized to A. fumigatus by specific IgE and skin prick testing.…”

Section: Resultsmentioning

confidence: 99%

Multifocal pulmonary aspergillomas: case series and review

Pendleton

Denning

2012

Annals of the New York Academy of Sciences

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“…Pulmonary nodules are the most common visual indicator of cryptococcosis, but these nodules are not specific to pulmonary cryptococcosis. They can mimic lung cancer, pulmonary tuberculosis, bacterial pneumonia, and other pulmonary mycoses, both clinically and radiologically [5]. The patient should be treated promptly after the diagnosis of pulmonary cryptococcosis with an antifungal therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary cryptococcosis is a rare infection that can be lethal in immunocompromised patients and behaves as an opportunistic invasive fungal infection [4]. Therefore, it is important for clinicians to differentiate between malignant pulmonary nodules and pulmonary cryptococcosis [5].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Nodule in a Patient with Oral and Lung Cancer: Cryptococcus Infection

et al. 2019

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Pulmonary nodules are frequently considered to be a metastatic disease or primary lung tumors in oral cancer patients. We present a case of pulmonary cryptococcosis in a 68-year-old man with oral and lung cancer. This lung cancer was treated with thoracoscopic resection of the right inferior lobe and mediastinal lymph node dissection. Lower gingival cancer was treated with a mandibulectomy, neck dissection, and reconstruction after chemoradiotherapy. A 20 mm cavitary nodule appeared at the left lung S6 one-month after surgery, during post-operative computed tomography. Thoracoscopic partial resection of the left inferior lobe was performed under the suspicion of lung metastasis. Pathology results revealed a pseudo-epithelial granuloma with necrosis and many yeast-shaped fungi with capsules. A pathological diagnosis of Cryptococcus infection was made. The patient was prescribed the antifungal agent fosfluconazole, which was administered intravenously for 1 week and intraoral fluconazole for 12 months. No recurrence of the Cryptococcus infection has been noted after 1.5 years.

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“…and the development and widespread application of organ transplantation. [1,2,6,7] It has already become one of the most common complications for AIDS in foreign countries. [8] Ten of the 43 cases in our study occurred between 1983 and 2000, while the other 33 patients (76.7%) were infected in recent years.…”

Section: Discussionmentioning

confidence: 99%