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

Wang,Dongxu; Wu,Chongchong; Gao,Jie; Zhao,Shaohong; Ma,Xidong; Wei,Bo; Feng,Limin; Wang,Yuguang; Xue,Xinying

doi:10.3892/etm.2018.6745

December-2018 Volume 16 Issue 6

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December-2018 Volume 16 Issue 6

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Article Open Access

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

Authors:
- Dongxu Wang
- Chongchong Wu
- Jie Gao
- Shaohong Zhao
- Xidong Ma
- Bo Wei
- Limin Feng
- Yuguang Wang
- Xinying Xue
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Affiliations: Department of CT Diagnosis, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, Heilongjiang 161006, P.R. China, Department of Radiology, Chinese PLA General Hospital, Beijing 100038, P.R. China, Department of Pathology, Chinese PLA General Hospital, Beijing 100038, P.R. China, Department of Respiratory Disease, School of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261053, P.R. China, Department of Thoracic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China, Department of Respiratory Disease, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, P.R. China

Copyright: © Wang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 4437-4444
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Published online on: September 17, 2018

https://doi.org/10.3892/etm.2018.6745
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Abstract

The manifestations of pulmonary cryptococcosis with multiple nodules or masses on computed tomography (CT) are diverse and difficult to differentiate from those of lung cancer and pulmonary tuberculosis. The present study compared the multislice spiral CT signs with pathological results and used the pathological results to explain the CT signs with the aim of improving the accuracy of the diagnosis of this disease. A retrospective analysis of 20 patients with primary pulmonary cryptococcosis with multiple nodules or masses was performed. Based on the CT signs, eight patients had been misdiagnosed with lung cancer accompanied by intrapulmonary metastasis andthree patients had been misdiagnosed with tuberculosis. The major CT manifestations were a cluster of nodules or masses located within 2 cm below the pleura and distributed along the bronchi. A total of nine patients had primary lesions with diameters of 1.1‑2.0 cm and 12 patients had satellite lesions with diameters of 0.1‑1.0 cm. Regarding treatment, 5 patients underwent surgical monotherapy, 12 patients underwent antifungal monotherapy and three patients received surgery in combination with antifungal therapy. HE staining indicated that Cryptococcus neoformans was engulfed by macrophages, which were surrounded by massive infiltrating lymphocytes and a large amount of fibrous tissue, which formed multinucleated macrophages or granulomas. Periodic acid‑Schiff staining was positive and acid fast staining was negative. In conclusion, comparison of CT signs with the pathological manifestation of pulmonary cryptococcosis with multiple nodules or masses indicated that the pathological results may explain certain imaging signs. Combination of CT and pathological examination may provide a deeper understanding of this disease and improve the accuracy of its diagnosis.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

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

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