1 遵义医科大学附属医院病理科，贵州 遵义 563000
2 遵义医科大学附属医院影像科，贵州 遵义 563000
Eight cases of pulmonary cryptococcosis and literature review
This work was supported by Guizhou Department of Science and Technology, China[Qiankehe LH zi (2015)7556].
To explore the clinical manifestations, clinicopathological features, the methods of diagnosis and treatment in pulmonary cryptococcosis (PC), we retrospectively analyzed the clinical data of 8 PC patients admitted by the Affiliated hospital of Zunyi Medical University from 2014 to 2018, which included the clinicopathological parameters, Hematoxylin eosin (HE) staining, special staining and other relevant materials, and we reviewed the related literatures. All of the 8 PC patients were normal immune population, and all of them denied contact history of pigeon dung. Seven of patients showed symptoms of cough, expectoration or chest pain, while one patient had no obvious symptoms. The imaging examinations were mainly single or multiple nodules and lumps, as well as patchy exudation. These were considered for lung cancer, tuberculosis, pneumonia, inflammatory pseudotumor, and none for pulmonary fungal disease. All the 8 cases presented chronic inflammation and granulomatous lesions, and the staining of Schiff hyperiodic acid and hexamamine silver was helped to find cryptococcus. Only surgical lobectomy was performed in 7 patients, 1 patient was treated with pulmonary puncture and systemic antifungal drugs, there was no recurrence during the follow-up. Most PC patients have no obvious immune function impairment, no special characteristics for clinical and imaging. Cryptococcus spores can be found in most cases by histopathology, and special staining such as hexamine silver and Schiff hyperiodic acid is helpful for pathological diagnosis. Surgical treatment of pulmonary cryptococcosis is still a common method. Patients with PC with normal immune function need to be followed up closely if they do not receive systematic antifungal treatment after lobectomy. Fluconazole and itraconazole are still classic medical treatments.
pulmonary cryptococcosis; clinical features; pathological diagnosis