Computerized tomography findings in primary pulmonary fungal infections / 中华传染病杂志

ABSTRACT

Objective To evaluate the findings of computerized tomography (CT) imaging in patients with primary pulmonary fungal infections.Methods CT findings and clinical data of 18 cases of primary pulmonary fungal infections from 2004 to 2012 were retrospectively analyzed.The diagnoses of all patients were confirmed by pathology or serology.Results The CT of primary pulmonary fungal infections showed soft tissue density nodules in 15 out of 18 cases,and masses in 3 out of 18.By pathology or serological examination,there were 12 cases of Aspergillus infections,3 cases of cryptococcal infections and 3 cases of coccidioidomycosis.The CT findings of all of the 12 cases of Aspergillus infection showed quasi-circular shaped lesions,with lobulation and spiculation (6/12),bronchial through syndrome (3/12),the air crescent sign (6/12),or mediastinal/hilar lymphadenopathies (3/12).Six cases presenting air crescent sign were all diagnosed with primary pulmonary aspergillosis.Among 12 aspergillosis cases,6 cases underwent CT enhancement scan,among which 3 showed no enhancement and 3 showed slight enhancements.The CT findings of all eases of Cryptococcus neoformans infections were cauliflower-like shape,with lobulation,spiculation,and no focal point calcification or mediastinal/hilar lymphadenopathies.After enhancement,all of the lesions were enhanced heterogeneously.The CT findings of all the coccidioidomycosis were irregular shaped lesions with halo sign and mediastinal/hilar lymphadenopathies.All 3 cases of halo signs were diagnosed with primary coccidioidal infections.Conclusions The CT findings of primary pulmonary fungal infections have certain characteristics.Diagnosis could be made based on CT imaging together with clinical manifestations before pathological results are available.