Clinical features of pulmonary cryptococcosis in thin-section CT in immunocompetent and non-AIDS immunocompromised patients

Radiol Med. 2020 Jan;125(1):31-38. doi: 10.1007/s11547-019-01088-8. Epub 2019 Oct 5.

Abstract

Rational and objectives: To compare thin-section computed tomography (CT) features of pulmonary cryptococcosis (PC) in immunocompetent and non-AIDS immunocompromised patients.

Materials and methods: We retrospectively reviewed CT findings of 18 immunocompetent and 24 non-AIDS immunocompromised patients with clinically proven PC. Different patterns of pulmonary abnormalities between the two groups of patients were compared by Fisher's exact test.

Results: Pulmonary nodules were present in 37 of the 42 patients. Masses were detected in 16 patients and consolidation in 9. There were 12 patients with a solitary nodule or mass. Masses were associated with nodules in 12 patients. Consolidation was associated with nodules/masses in nine patients. The nodules/masses were associated with cavitations in 13 patients. Margination of nodules/masses was well defined in nine patients and ill-defined in 33. The abnormalities were predominantly distributed in the peripheral region of the lung (n = 29, 69.0%). The presence of cavitations in nodules/masses was significantly more frequent in non-AIDS immunocompromised than in immunocompetent patients (P = 0.001).

Conclusions: The most common thin-section CT feature of PC was pulmonary nodules/masses, which were ill-defined and located peripherally. Cavitations within nodules/masses were more commonly found in non-AIDS immunocompromised patients. PC should be considered in the differential diagnosis of pulmonary nodules/masses.

Keywords: Computed tomography; Cryptococcosis; Immunology; Pulmonary.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cryptococcosis / diagnostic imaging*
  • Cryptococcosis / pathology
  • Cryptococcosis / surgery
  • Female
  • Humans
  • Immunocompetence*
  • Immunocompromised Host*
  • Lung Diseases, Fungal / diagnostic imaging*
  • Lung Diseases, Fungal / pathology
  • Lung Diseases, Fungal / surgery
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*