© 2005 BMJ Publishing Group Ltd & British Thoracic Society
Images in Thorax
An unique case of primary pulmonary cryptococcosis with extensive chest wall invasion
Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan
Correspondence to:
Correspondence to:
Dr H Kanazawa
Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abenoku, Osaka 545-8585, Japan; kanazawa-h@med.osaka-cu.ac.jp
| The first 150 words of the full text of this article appear below. |
An abnormality was found on the chest radiograph of a 56 year old man during a medical check up. Three months later the bloody sputum and left chest pain were aggravated; the left chest was swollen and pain increased and the patient was admitted a month later. At admission the chest radiograph revealed a left upper lobe mass and a chest CT scan showed extension into the chest wall (fig 1A
and B). There was tenderness in the left anterior thoracic region and an elastic hard mass with an unclear boundary and a diameter of 5 cm was palpated but no neurological abnormality was noted. A transbronchial lung biopy specimen was taken but no malignancy was found. Although he had no contact with birds, did not habitually drink alcohol and was not immunosuppressed, Cryptococcus neoformans was detected in lung biopsy samples. Treatment with 200 mg fulconazole was initiated but the
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