原发性肺隐球菌病的影像学表现

Radiological characteristics of primary pulmonary crytococcosis

目的探讨原发性肺隐球菌病的影像学表现,提高对本病的认识。方法回顾性分析20例经病理证实的原发性肺隐球菌病的临床资料及影像学资料,结合文献分析其特点。结果原发性肺隐球菌病多见于中青年男性。临床症状轻微,主要表现为咳嗽及胸痛。无症状8例。影像表现为多发结节团块影10例,孤立不规则团块影5例,单发结节2例,实变影3例。病灶多位于肺野外带及胸膜下区。经过治疗,短期内(2～6个月)结节病灶可快速进行性缩小,数目减少;随后病灶吸收消散较慢,约1～2年,部分长达5年。结论原发性肺隐球菌病肺部影像表现多样,CT检查有助于PPC的诊断和随访。

Objective To describe the radiological characteristics, and raise the recognition of primary pulmonary crytococcosis （PPC）. Methods The clinical and imaging data of 20 patients with PPC pathologically proved was retrospective studied. Results Most of the patients with PPC were young, middle-aged and male predominant. The clinical symptom was mild, with main manifestations of cough and chest pain. Eight cases were entirely symptom free. Imaging manifestations were multiple pulmonary nodules or masses （n = 10）, solitary nodules （ n = 2 ）, masses （ n = 5 ）, and consolidation （ n = 3 ）. Location of the abnormalities was outer zone and subpleural predominant. After appropriate treatment, good response and relative fast resolution were observed with reduction of number and size of nodules in first 2 to 6 months of treatment, but the resolution slowed down afterward. The abnormalities lasted one to two years in most of the cases, but could last for as long as five years in some cases. Conclusion PPC showed variety abnormalities in the images, CT examination was beneficial to PPC diagnosis and follow up the response to treatment.