KMID : 0882420150890010091
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Korean Journal of Medicine 2015 Volume.89 No. 1 p.91 ~ p.96
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A Case of Disseminated Cryptococcosis Mimicking Lung Cancer and Prostate Cancer in an Immunocompetent Patient: A Review of the Literature
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Lee Yun-Kyoung
Kim Ju-Hyeon Seo Hyung-Il Park Hyung-Chul Oh Yeon-Mok Lee Sang-Do Lee Jae-Seung
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Abstract
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Cryptococcosis can occur in immunocompetent patients; in fact, it accounts for 20% of all cryptococcal infections. In immunocompetent patients, although clinical symptoms may not be obvious, cryptococcosis should be considered in the differential diagnosis for cancer and other diseases. We recently encountered a case of disseminated cryptococcosis involving the lung and prostate. A 71-year-old male patient was referred for evaluation of a large pleural effusion. He was a 40 pack-years ex-smoker, and showed no evidence of immunodeficiency. Chest computed tomography and positron emission tomography images suggested primary lung cancer with pleural metastases and prostate cancer. Tuberculous pleurisy was suspected due to a lymphocyte-dominant exudative pleural effusion and high level of adenosine deaminase. Prostate and bronchoscopic biopsies demonstrated chronic granulomatous inflammation, and periodic acid Schiff¡¯s and Grocott¡¯s methenamine silver staining confirmed cryptococcosis in both specimens. Antifungal therapy with fluconazole was started, and follow-up images showed complete resolution of the pleural effusion.
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KEYWORD
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Immunocompetent, Cryptococcosis, Lung neoplasms, Prostatic neoplasms, Fluconazole
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