Primary Pulmonary Cryptococcosis Confused with Lung Cancer by Transbronchial Biopsy: Demonstration by Three-Dimensional Computed Tomography
Hiroshi Terasaki Kiminori Fujimoto Shigenobu Meno Masaaki Nonoshita Reika Kinoshita Yoshio Ogoh Masafumi Uchida Naofumi Hayabuchi
Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
Routine chest radiographs of a 52-year-old woman displayed abnormal opacities in the right lower lung field. A computed tomographic (CT) scan of the chest disclosed irregular nodular opacities in the peripheral zone of the right S6. Reconstructed three-dimensional images obtained by helical CT displayed the lesions as agglutinated small nodules, with other small nodules near the bronchi appearing as "tree-in-bud" formations. Specimens obtained by transbronchial lung biopsy of the right B6b revealed atypical glandular structures, thus leading to suspected adenocarcinoma of primary lung cancer. A right lower lobectomy was performed; cut-surface specimens of the resected tissues showed multiple lobulate, milky-white nodules near the bronchi. Histopathologic examination found no malignant cells. PAS staining revealed numerous cryptococcal organisms, thus yielding the final diagnosis of primary pulmonary cryptococcosis.
Cyptococcosis Lung cancer Three-dimensional CT
Received 平成10年12月8日
JJRS, 37(8): 667-671, 1999