Clinicopathologic Features of Pulmonary Cryptococcus

Abstract

SESSION TITLE: Chest Infections SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Pulmonary cryptococcal infection is commonly seen in immunocompromised patients (ProPts), although immunocompetent patients (PePts) may also be infected. Our aim is to describe the clinicopathologic features of pulmonary cryptococcosis METHODS: We reviewed the clinicopathologic data of 21 patients with pulmonary cryptococcosis who were admitted to our hospital from 2008 to 2016. It was pathologically proven in all patients RESULTS: The patients were 14 ProPts and 7 PePts. Among 14 ProPts, it was composed of 5 cancer patients, 4 diabetes mellitus, 3 hematologic malignancy, 1 post-transplanted, and 1 rheumatoid arthritis. Mean patient age was 62 years, but, age of PePts was lower (mean age : 50). Male to female ratio was 1:1 in all patients. But, male ratio was more in PePts (71.4%) than ProPts (42.9%). Two-thirds of patients were asymptomatic. The pulmonary lesion was incidentally detected in health medical examination or during follow-up radiology of previous disease. Lesions were more common in lower than upper lung (5 pts, 71.4%) of PePts, but common in upper than lower (8 pts, 64.2%) of ProPts. More lesions (12 pts, 57.1%) were characterized by patchy consolidations, which was described as unusual. But, in 3 patients, cavitary lesion, suspicious for malignancy, was found. Of all patients, 14 were diagnosed by surgical complete removal, and 7 diagnosed by bronchoscopy. In pathologic features, most of cases (20 cases) showed the granuloma. But, necrosis was shown in 9 cases (8 in ProPts and 1 PePts). All patients had been treated by antifungal agent and showed a favorable outcome. CONCLUSIONS: Clinicopathologic features of pulmonary cryptococcosis was variable between ProPts and PePts. Early recognition and pathologic examination may help with improvement of its diagnosis and prognosis. CLINICAL IMPLICATIONS: Pulmonary cryptococcal infection is commonly seen in immunocompromised patients (ProPts), although immunocompetent patients (PePts) may also be infected. but, clinicopathologic features of pulmonary cryptococcosis was variable between ProPts and PePts. DISCLOSURE: The following authors have nothing to disclose: Yu-Deok Choi, Sang-Yun Song, Chang-Soo Park No Product/Research Disclosure Information