Department of Respiratory Medicine, Fuzhou Pulmonary Hospital of Fu Jian, Educational Hospital of Fujian Medical University, Fuzhou, China
Copyright 2016, American College of Chest Physicians. All Rights Reserved.
SESSION TITLE: Infections: Fungal
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM
PURPOSE: To investigate the clinicopathologic, radiological features and the underlying reasons of preoperative misdiagnosis of lung cancer with pulmonary cryptococcosis (PC).
METHODS: A total of 7 patients of lung cancer with coexisting PC，who were admitted to Fuzhou Pulmonary Hospital of Fu Jian from 2007 to 2015，were studied and the medical literatures were reviewed.
RESULTS: 6 of 7 patients (85.7%) were female and mean patient age was 55 years. Only 1 case had a history of diabetes mellitus. The other 6 patients had no other immunosuppressive diseases except coexisting lung cancer. Computed tomography (CT) scan was performed in all the cases. Of the 7 cases，6 cases of pulmonary carcinoma and 5 cases of PC all manifested as solitary nodular shadows; 1 case of PC showed the type of multiple nodules; 1 case with coexisting lung cancer and PC manifested as a large flake-like infiltrated shadow in the right lower lobe. 7 cases were confirmed by pathological examinations and showed lung adenocarcinoma with coexisting PC. Surgical resection was performed in 6 cases and the patients were given oral itraconazole after the operation. 2 of them were also treated with antineoplastic chemotherapy. The above 6 patients all have been under a careful observation and are presently well since the resection. 1 case was treated with antifungal therapy initially, then in combination with antineoplastic chemotherapy, but failed to improve.
CONCLUSIONS: PC coexisting with pulmonary carcinoma is rare. PC can manifest as pulmonary nodule and mimic malignant lesion, so it must be considered on a differential diagnosis of pulmonary nodules.
CLINICAL IMPLICATIONS: To deepen the understanding of the disease.
DISCLOSURE: The following authors have nothing to disclose: Jinbao Huang, Hong-yan LI, Chang-qing Lan, Hong-ying Zhang, Xin-Hang Wang, Shu-xing Chen, Qing-hua Lin, Heng Wen
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