Pulmonary cryptococcosis: CT findings in immunocompetent patients
Pulmonary cryptococcosis: CT findings in immunocompetent patients
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DOI：
10.1148/radiol.2361040460
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发表时间：
2005-07-01
期刊：
影响因子：
19.7
通讯作者：
Ryu, JH
中科院分区：
文献类型：
--
作者：
Lindell, RM;Hartman, TE;Ryu, JH
目得：回顾性评估的计算机断层扫描（CT）的结果在免疫功能正常的患者与肺隐球菌病。材料和方法：机构审查委员会的批准获得了豁免知情同意书，研究符合健康保险流通和责任法案的要求。10例免疫功能正常的临床证实的肺隐球菌病患者的胸部CT扫描由四名评论者回顾性审查。肺隐球菌病的诊断标准是：（a）肺活检时组织病理学上存在微生物，或（B）呼吸道标本培养阳性或血清隐球菌抗原检测阳性，并有活动性肺部感染的临床或影像学证据。患者包括6名女性和4名男性，年龄范围为46至73岁（平均59岁）。对结节、肿块、磨玻璃样衰减或模糊增强区、实变区、空洞区、胸腔积液、线状阴影、间隔增厚、淋巴结病、实质受累程度和分布进行了评价。多发结节（n = 7）比孤立结节（n = 2）更常见。结节最常占据肺实质的10%以下（n = 7），测量直径小于10 mm（n = 7），并以中肺和上肺为主（n = 6）。大多数结节边界清楚，边缘光滑（n = 7）。多发性结节通常分布于双侧（n = 5）。肿块（n = 2），淋巴结肿大（n = 2），实变区（n = 2），模糊增加的衰减（n = I），胸腔积液（n = I）和空洞（n = 1）的区域是罕见的。结论：CT最常见的免疫功能正常的肺隐球菌病患者的肺结节。结节多为多发、小、边界清楚、边缘光滑，以中上肺为主。((c))RSNA，2005年。
PURPOSE: To evaluate retrospectively the computed tomographic (CT) findings in immunocompetent patients with pulmonary cryptococcosis.MATERIALS AND METHODS: Institutional review board approval was obtained with a waiver of informed consent, and the study complied with requirements of the Health Insurance Portability and Accountability Act. Chest CT scans of 10 immunocompetent patients with clinically proved pulmonary cryptococcosis were retrospectively reviewed by four reviewers in consensus. Criterion for diagnosis of pulmonary cryptococcosis was (a) the histopathologic presence of the organism at lung biopsy or (b) a positive culture of a respiratory specimen or positive serum cryptococcal antigen test with clinical or radiographic evidence of active pulmonary infection. Patients included six women and four men ranging in age from 46 to 73 years (mean, 59 years). Scans were evaluated for nodules, masses, areas of ground-glass attenuation or of hazy increased attenuation, areas of consolidation, areas of cavitation, pleural effusions, linear opacities, septal thickening, lymphadenopathy, extent of parenchymal involvement, and distribution.RESULTS: The most common CT finding was pulmonary nodules (n = 9). Multiple nodules (n = 7) were more common than solitary nodules (n = 2). Nodules most commonly occupied less than 10% of the pulmonary parenchyma (n = 7), measured less than 10 mm in diameter (n = 7), and had middle and upper lung predominance (n = 6). The majority of the nodules were well defined with smooth margins (n = 7). Multiple nodules were usually bilaterally distributed (n = 5). Masses (n = 2), lymphadenopathy (n = 2), areas of consolidation (n = 2), areas of hazy increased attenuation (n = I), pleural effusion (n = I), and areas of cavitation (n = 1) were uncommon.CONCLUSION: CT most commonly demonstrated pulmonary nodules in immunocompetent patients with pulmonary cryptococcosis. The nodules were most often multiple, small, well defined, and smoothly marginated with middle and upper lung predominance. ((c)) RSNA, 2005.