原発性肺クリプトコッカス症の2例

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  • TWO CASES OF PRIMARY PULMONARY CRYPTOCOCCOSIS

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Patient 1, a 72-year-old woman was seen at the hospital because of an abnormal shadow on chest radio-graphs. CT revealed an irregularly shaped nodular shadow measuring 2cm in diameter in the right S 8 segment, and therefore, a partial lung resection was performed under thoracotomy. Histopathologic examination demonstrated a number of globular organisms positive to the PAS stain in a foreign body granuloma. Patient 2, a 38-year-old woman was seen at the hospital because chest radiographs revealed an abnormal shadow at a medical check up. CT showed a well-circumscribed nodular shadow measuring 1cm in diameter with a daughter nodule in the right S 6 segment. After a thoracoscopic partial lung resection, many globular organisms positive to the PAS and Grocott stain were noted in the tumor, which demonstrated coagulation necrosis. None of these patients had any underlying diseases except the pulmonary lesion, leading to a diagnosis of primary pulmonary cryptococcosis. Recurrences have not been encountered for postoperative 4 years in patient 1 and for 1 year and 6 months in patient 2.<br>This disease is a comparatively rare entity. It lacks distinctive clinical features or imaging findings, and presents difficulties in preoperative diagnosis in many cases. The lesion is liable to develop right under the pleura, and often imparts a solitary nodular shadow. It is considered to be a good indication for thoracoscopic surgery which is a less invasive approach.

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