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KMID : 0383820140770060266
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Tuberculosis and Respiratory Diseases
2014 Volume.77 No. 6 p.266 ~ p.270
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Pulmonary Cryptococcosis That Mimicked Rheumatoid Nodule in Rheumatoid Arthritis Lesion
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Jang Dong-Won
Jeong In-A
Kim Seon-Jae
Kim Seok-Won
Park Soo-Yeon
Kwon Yong-Hwan
Jeong Yeon-Oh
Lee Ji-Yeon
Kim Bo-Sung
Kim Woo-Shik
Joh Joon-Sung
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Abstract
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Recently, the incidence of pulmonary cryptococcosis is gradually increasing in rheumatoid arthritis (RA) patients. Pulmonary rheumatoid nodules (PRN) are rare manifestations of RA. Eighteen months ago, a 65-year old woman was admitted to hospital due to multiple nodules (2.5×2.1×2 cm) with cavitations in the right lower lobe. She was diagnosed with RA three year ago. She had been taking methotrexate, leflunomide, and triamcinolone. A video-assisted thoracoscopic surgery biopsy was performed and PRN was diagnosed. However, a newly growing huge opacity with cavitation was detected in the same site. Pulmonary cryptococcal infection was diagnosed through a transthoracic computed tomograpy guided needle biopsy. Cryptococcus antigen was detected in serum but not in cerebrospinal fluid. The patient was treated with oral fluconazole which resulted clinical improvement and regression of the nodule on a series of radiography. Herein, we report the case of pulmonary cryptococcosis occurring in the same location as that of the PRN.
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KEYWORD
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Cryptococcus, Cryptococcosis, Rheumatoid Nodule, Arthritis, Rheumatoidcryptococcosis
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