Correlation between Clinical Characteristics and Chest Computed Tomography Findings of Pulmonary Cryptococcosis

Abstract

Objective. The aim of this study was to review HIV-negative patients with pulmonary cryptococcosis to analyze the correlations between clinical characteristics and chest computed tomography (CT) findings. Methods. We retrospectively analyzed medical records of 16 HIV-negative patients with pulmonary cryptococcosis diagnosed at our institution, and clinical characteristics of the patients with nodules or masses without ground-glass attenuation (GGA)/consolidation type were compared with those of patients with inclusive GGA or consolidation type. Results. Host status was immunocompromised (81.2%) in most of the patients, and 6 (37.5%) were asymptomatic. The most frequent radiologic abnormalities on chest CT scans were one or more nodules (87.5%), GGA (37.5%), and consolidations (18.8%). Most lesions were located in the lower lung. Levels of hemoglobin and platelets were significantly lower in patients with inclusive GGA or consolidation type. Although the differences were not significant, patients with inclusive GGA or consolidation type tended to have a C-reactive protein level of ≥1.0 mg/dL. Conclusion. If a patient with anemia and thrombocytopenia shows GGA or consolidation in the lung, pulmonary cryptococcosis should be given careful consideration.

Plain and contrast‑enhanced chest computed tomography scan findings of pulmonary cryptococcosis in immunocompetent patients

“…Previously, pulmonary cryptococcosis was considered to occur mainly in immunocompromised individuals, such as individuals with AIDS, as well as in individuals that underwent organ transplantation or had a hematologic malignancy, and to be rare in immunocompetent patients (4). Recently, it has reported that the incidence of pulmonary cryptococcosis is increasing (12).…”

“…These two species are genetically associated with each other; however, they differ genotypically, epidemiologically, ecologically, geographically and phenotypically (2,3). Cryptococcus neoformans occurs most frequently in immunocompromised individuals, particularly those with acquired immunodeficiency syndrome (AIDS) or other causes of impaired T cell-mediated immunity, and less frequently infects immunocompetent patients (4). By contrast, Cryptococcus gattii is more likely to infect healthy individuals, and is associated with tropical and subtropical regions (5).…”

Comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by CT and pathology

“…Intrapulmonary metastasis of lung cancer manifests as multiple intrapulmonary nodules or masses with signs on CT including lobulation, irregular margins, spiculation, vascular convergence sign and pleural indentation ( 7 – 9 ). Pulmonary tuberculosis on CT manifests as multiple intrapulmonary nodules or masses presenting signs including irregular margins, satellite lesions and tree-in-bud sign ( 10 , 11 ).…”

A case of pulmonary cryptococcosis with large pericardial effusion diagnosed using cervical lymph node biopsy

“…Immunocompetent patients tend to present with nodular or lump-shaped lesions that may vary according to differences in the immune system status. 12 The results of laboratory tests for PC tend to be nonspecific. 7,11 In some patients, lesions may appear as shadowy patches that are often misdiagnosed as pneumonia or tuberculosis 7 ; in others, nodular lesions may form granulomas.…”

“…If a patient with anemia and thrombocytopenia shows ground-glass attenuation or consolidation in the lung, pulmonary cryptococcosis should be given careful consideration. 12 The results of laboratory tests for PC tend to be nonspecific. However, tests involving blood, sputum, urine, pleural fluid, and bronchoalveolar lavage fluid; pathogenic examinations; and biopsy cultures are instrumental to an accurate diagnosis.…”