HRCT Finding of Pulmonary Cryptococcosis in Immune Competent Patients

ABSTRACT

PURPOSE: To determine the HRCT finding of pulmonary cryptococcosis in immunocompetent patients. MATERIALS AND METHODS: The HRCT scans and chest radiographs of five patients with pulmonary cryptococcosis were retrospectively reviewed, the diagnosis being proven by the presence of the organism in histopathologic specimens obtained during CT-guided biopsy (n = 4) or medistinoscopic biopsy (n = 1). All patients were immunocompetent. HRCT scans and chest radiographs were characterized according to morphology [consoli-dation, nodule, ground-glass opacity (GGO), interstitial thickening], location, airbronchogram, and the pres-ence or absence of mediastinal or hilar lymphadenopathy. RESULTS: Consolidation was present in three of five patients, and in two of the three, ill-defined, spiculated nodules were also present. One patient had multiple, small, well-defined nodules. One had diffuse interstitial thickening (GGO, nodular thickening of bronchovascular bundles and interlobular septa), with massive mediastinal and right hilar lymphadenopathy. The location of the consolidation and nodules was mainly peripheral, and in three patients with consolidation, the presence of air bronchograms was noted. CONCLUSION: The HRCT findings of pulmonary cryptococcosis in immunocompetent patients are peripheral consolidation with airbronchogram and/or ill defined nodules.