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Comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by CT and pathology

The manifestations of pulmonary cryptococcosis with multiple nodules or masses on computed tomography (CT) are diverse and difficult to differentiate from those of lung cancer and pulmonary tuberculosis. The present study compared the multislice spiral CT signs with pathological results and used the...

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Autores principales: Wang, Dongxu, Wu, Chongchong, Gao, Jie, Zhao, Shaohong, Ma, Xidong, Wei, Bo, Feng, Limin, Wang, Yuguang, Xue, Xinying
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257807/
https://www.ncbi.nlm.nih.gov/pubmed/30542394
http://dx.doi.org/10.3892/etm.2018.6745
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author Wang, Dongxu
Wu, Chongchong
Gao, Jie
Zhao, Shaohong
Ma, Xidong
Wei, Bo
Feng, Limin
Wang, Yuguang
Xue, Xinying
author_facet Wang, Dongxu
Wu, Chongchong
Gao, Jie
Zhao, Shaohong
Ma, Xidong
Wei, Bo
Feng, Limin
Wang, Yuguang
Xue, Xinying
author_sort Wang, Dongxu
collection PubMed
description The manifestations of pulmonary cryptococcosis with multiple nodules or masses on computed tomography (CT) are diverse and difficult to differentiate from those of lung cancer and pulmonary tuberculosis. The present study compared the multislice spiral CT signs with pathological results and used the pathological results to explain the CT signs with the aim of improving the accuracy of the diagnosis of this disease. A retrospective analysis of 20 patients with primary pulmonary cryptococcosis with multiple nodules or masses was performed. Based on the CT signs, eight patients had been misdiagnosed with lung cancer accompanied by intrapulmonary metastasis andthree patients had been misdiagnosed with tuberculosis. The major CT manifestations were a cluster of nodules or masses located within 2 cm below the pleura and distributed along the bronchi. A total of nine patients had primary lesions with diameters of 1.1–2.0 cm and 12 patients had satellite lesions with diameters of 0.1–1.0 cm. Regarding treatment, 5 patients underwent surgical monotherapy, 12 patients underwent antifungal monotherapy and three patients received surgery in combination with antifungal therapy. HE staining indicated that Cryptococcus neoformans was engulfed by macrophages, which were surrounded by massive infiltrating lymphocytes and a large amount of fibrous tissue, which formed multinucleated macrophages or granulomas. Periodic acid-Schiff staining was positive and acid fast staining was negative. In conclusion, comparison of CT signs with the pathological manifestation of pulmonary cryptococcosis with multiple nodules or masses indicated that the pathological results may explain certain imaging signs. Combination of CT and pathological examination may provide a deeper understanding of this disease and improve the accuracy of its diagnosis.
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spelling pubmed-62578072018-12-12 Comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by CT and pathology Wang, Dongxu Wu, Chongchong Gao, Jie Zhao, Shaohong Ma, Xidong Wei, Bo Feng, Limin Wang, Yuguang Xue, Xinying Exp Ther Med Articles The manifestations of pulmonary cryptococcosis with multiple nodules or masses on computed tomography (CT) are diverse and difficult to differentiate from those of lung cancer and pulmonary tuberculosis. The present study compared the multislice spiral CT signs with pathological results and used the pathological results to explain the CT signs with the aim of improving the accuracy of the diagnosis of this disease. A retrospective analysis of 20 patients with primary pulmonary cryptococcosis with multiple nodules or masses was performed. Based on the CT signs, eight patients had been misdiagnosed with lung cancer accompanied by intrapulmonary metastasis andthree patients had been misdiagnosed with tuberculosis. The major CT manifestations were a cluster of nodules or masses located within 2 cm below the pleura and distributed along the bronchi. A total of nine patients had primary lesions with diameters of 1.1–2.0 cm and 12 patients had satellite lesions with diameters of 0.1–1.0 cm. Regarding treatment, 5 patients underwent surgical monotherapy, 12 patients underwent antifungal monotherapy and three patients received surgery in combination with antifungal therapy. HE staining indicated that Cryptococcus neoformans was engulfed by macrophages, which were surrounded by massive infiltrating lymphocytes and a large amount of fibrous tissue, which formed multinucleated macrophages or granulomas. Periodic acid-Schiff staining was positive and acid fast staining was negative. In conclusion, comparison of CT signs with the pathological manifestation of pulmonary cryptococcosis with multiple nodules or masses indicated that the pathological results may explain certain imaging signs. Combination of CT and pathological examination may provide a deeper understanding of this disease and improve the accuracy of its diagnosis. D.A. Spandidos 2018-12 2018-09-17 /pmc/articles/PMC6257807/ /pubmed/30542394 http://dx.doi.org/10.3892/etm.2018.6745 Text en Copyright: © Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Articles
Wang, Dongxu
Wu, Chongchong
Gao, Jie
Zhao, Shaohong
Ma, Xidong
Wei, Bo
Feng, Limin
Wang, Yuguang
Xue, Xinying
Comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by CT and pathology
title Comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by CT and pathology
title_full Comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by CT and pathology
title_fullStr Comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by CT and pathology
title_full_unstemmed Comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by CT and pathology
title_short Comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by CT and pathology
title_sort comparative study of primary pulmonary cryptococcosis with multiple nodules or masses by ct and pathology
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257807/
https://www.ncbi.nlm.nih.gov/pubmed/30542394
http://dx.doi.org/10.3892/etm.2018.6745
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