亚临床症状肺隐球菌病的影像学表现

Imaging manifestations of subclinical pulmonary cryptococcosis

目的探讨亚临床症状型肺隐球菌病的影像学表现。方法结合国内外文献回顾分析经手术病理或穿刺活检证实的肺隐球菌病患者10例。结果本组肺隐球菌病的X线、CT表现可归纳为以下5种:①单发结节或肿块5例;②累及一个肺叶多发结节或肿块2例;③累及两个以上肺叶多发结节1例;④斑片与结节影混合病灶1例;⑤多发斑片影1例。病灶分布以两下肺叶为主:左下叶5例;右下叶3例;左上肺1例,右中肺1例。结论亚临床型肺隐球菌病的影像学表现以单发或多发结节影病灶为主,可伴有斑片影和空洞,诊断时需与肺癌、肺转移肿瘤鉴别。

Objective To study the X ray and CT features of subclinical pulmonary cryptococcosis. Methods X - ray and CT images of 10 cases of pulmonary cryptoccosis proven by pathological examinations were studied. Results There were five phenotypes of X - ray and CT findings in this group： ①solitary nodule or mass was found in 5 cases; ②multiple nodules or masses distributed within a single lobe in 2 cases; ③multiple modules distributed in multiple lobes in 1 case; ④nodules accompanying with patchy loci in 1 case, and ⑤ multiple patchy loci in 1 case. Most of the lesions were located within the bilateral lower lobes： 5 in left lower lobe; 3 in right lower lobe; 1 in left upper lobe; and 1 in right middle lobe. Conclusion Single nodule or mass accompanying with patchy loci or cavity is the common imaging findings of subclinical pulmonary cryptococcosis. Differential diagnosis includes lung cancer, metastasis tumors and tuberculosis.