Cryptococcus pneumonia: Helpful findings for diagnosing cryptococcal pneumonia on CT in residents

Abstract

Background: Pulmonary cryptococcosis has various CT findings which can be often misdiagnosed as other diseases to delay patient’s treatment. It is actually very difficult to diagnose pulmonary cryptococcal pneumonia on chest CT, especially for inexperienced residents. Purpose: To investigate whether there are new CT findings that may be helpful to residents when diagnosing cryptococcal pneumonia with CT. Materials and methods: We retrospectively reviewed chest CT findings of 23 patients with pathologically proven PC from 2007 to 2018 in our hospital. Eight residents independently read chest CT twice at regular intervals, and at the second reading, the patient’s clinical information and one additional CT finding were provided. Correlation between CT findings and diagnosis accuracy for cryptococcal pneumonia were compared by simple liner regression. Results: Most common pulmonary lesion identified on CT was multiple nodules (n = 15, 65.2%), followed by masses (n=8, 34.8%). The distribution of located within 2 cm below pleural and distributed along the bronchi, which 19 (82.6%) patients were observed in their CT images, and enhancement of nodule or mass were significant correlated for CT findings and diagnostic accuracy on cryptococcal pneumonia, which p-value were 0.018 and 0.007 respectively. Conclusion: In order to accurately diagnose pulmonary cryptococcal pneumonia, clinical information including the patient’s immune status and nodules clustered within 2 cm of the bronchi on the chest CT verified in this study are helpful to trainers Keywords: pulmonary; infection; cryptococcosis; radiographic features; diagnosis.