Pulmonary cryptococcosis presenting as necrotizing granuloma:a clinicopathologic analysis of 28 cases

Abstract

Abstract:

Objective To improve the understanding of pulmonary cryptococcosis (PC) presenting as necrotizing granuloma and to avoid the misdiagnosis through the analysis on clinical,pathological and radiological characteristics. Methods A retrospective review of the clinicopathologic and radiological records of 28 cases of PC presenting as necrotizing granuloma comfirmed by special stains. Results There were 14 males and 14 females,aging from 27 to 68 years (median,51 years).Twenty-seven cases were asymptomaic while only one had cough.The previous history was chronic disease or cancer in 5 cases.CT scan of all cases showed node mass and four of them had a cavity.All cases were observed as necrotizing granuloma microscopically.Cryptococcus neoformans were seen by grocott hexamine silver and PAS staining. Conclusions The majority of PC patients presenting as necrotizing granuloma had normal immune system.Imaging findings were generally mass or cavity.Naked eye specimens were similar to the cancer.It was hard to distinguish necrotizing granuloma from tuberculosis granuloma unless by special staining.

Key words: necrotizing granuloma, cryptococcosis, pulmonary

CLC Number:

R519.4

ZHANG Li-yan, ZHANG Dong-lei, TAN Xiao-ming, XIE Hui-kang. Pulmonary cryptococcosis presenting as necrotizing granuloma:a clinicopathologic analysis of 28 cases[J]. Chinese Journal of Mycology, 2017, 12(4): 212-215.

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