Clinicopathological characteristics of pulmonary cryptococcosis

Abstract Pulmonary cryptococcosis is a fungal infection caused by the inhalation of Cryptococcus neoformans, and may progress to disseminated disease, particularly in immunocompromised host such as acquired immunodeficiency syndrome. We reported a retrospective review of the 8 patients who had undergone surgical resection for pulmonary cryptococcosis during recent 12 years. There were 5 men and 3 women with a mean age of 49 years. The number of lesions was solitary in 4 patients and multiple in 4 patients. All patients had neither symptom from the lesion nor human immunodeficiency virus infection. The most common computed tomography finding was well-defined solid nodules (<2 cm) of the lung. The lesion size ranged from 0.8 to 2.0 cm with a mean of 1.3 cm. Pathologically, the resected specimen revealed Cryptococcus fungal bodies in all cases. After surgery, 4 patients were treated with systemic antifungal therapy (fluconazole), and the others had no treatment. In all patients, no sign of relapse was found during the postoperative follow-up period. Although the prognosis of present cases was excellent regardless of the treatment after the surgery, the recommendation for the treatment in patients with pulmonary cryptococcosis is oral or intravenous fluconazole therapy because of the possible development of subclinical systemic disseminated disease.