肺隐球菌2例误诊及1例正确诊断分析

目的提高肺隐球菌病早期正确诊断水平。方法对收治的3例病理确诊为肺隐球菌病患者的临床资料、影像学特征、病理学特点等进行回顾性分析。结果患者多有基础疾病或诱因,临床症状相对轻微,影像学表现以单发或多发结节肿块影为主,3例患者病理学检查可见隐球菌孢子。结论肺隐球菌病的诊断主要依靠穿刺后病理检查,但由于其流行病学特点、临床表现、影像学表现均无特异性且具有多样性,甚至病理学也具有一定的迷惑性,极易误诊为其他呼吸道疾病。为提高肺隐球菌病的诊断水平,我们认为应该关键在于提高临床医生对患者有潜在机会感染隐球菌的警惕性,提高放射科医生和病理科医生对本病特点的认识。

Objective To improve the diagnosis of pulmonary cryptoccosis early and correctly.Methods A retrospective analysis was performed on 3 cases of patients with pulmonary cryptococcosis with regard to their clinical data,imaging findings and pathology character.Results All patients had underlying diseases or causes, and their clinical manifestation lacked specificity or were asymptomatic. The imaging findings showed that the patients had solitary or multiple tubercle.The sporus of cryptoccosis were found in the slide of all patients. Conclusion The diagnosis of pulmonary cryptoccosis depends on the pathology biopsy. Because epidemiological feature, clinical manifestation, imaging findings and pathology character lack specificity, the patient of pulmonary cryptoccosis might be misdiagnosed easily. In order to improve the diagnosis of pulmonary cryptoccosis early and correctly, we think it is important to boost clinical doctor the vigilance of pulmonary cryptoccosis and to elevate the radiology doctor and pathology doctor the recognition of pulmonary cryptoccosis.