原发性肺新型隐球菌肉芽肿的手术治疗——附4例报告

SURGICAL TREATMENT OF PRIMARY PULMONARY CRYPTOCOCCAL GRANULOMA——REPORT OF 4 CASES

本文报道4例原发性肺新型隐球菌肉芽肿。该病无特异性临床征象,易误诊为肺癌。经严格选择有手术适应症的患者,手术可作为首选的治疗方法。本组4例均经手术治疗,效果满意,随访1年无复发或播散。

Primary pulmonary cryptococcal granu-loma is not common in Sichuan. The diag-nosis of this disease is difficult to makebecause the patient has no characteristicsymptoms and the chest X-ray findings ofthe mass are not easily differentiated fromcarcinoma of the lung. The incidence ofthis disease is apparetly increasing. Pulmonary cryptococcosis may be desse-minated hematogenously to the meningesand cryptococcal meninigtis is very difficultto treat.If the pulmonary lesion is localiz-ed, the patient's general condition is goodwith no evidence of systemic lupus erythe-matosis, diabetes, leukemia or lymphoma,partial resection of the lung is indicated.But, if the patient has a history of recentcryptococcal meningitis,surgery must be de-ferred. Four cases of primary pulmonary cryp-tococcal granuloma have been treated surgi-cally supplemented with medical therapy inthe First Affiliated Hospital from 1986to 1987.Follow-up of more than one year showedgood results in each case.