Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2020; 8(24): 6444-6449
Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6444
Clinical characteristics of pulmonary cryptococcosis coexisting with lung adenocarcinoma: Three case reports
Gui-Xian Zheng, Hai-Juan Tang, Zhi-Ping Huang, Hui-Ling Pan, Han-Yi Wei, Jing Bai
Gui-Xian Zheng, Hai-Juan Tang, Zhi-Ping Huang, Hui-Ling Pan, Han-Yi Wei, Jing Bai, Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Bai J and Zheng GX carried out the studies, collected the data, and drafted the manuscript; Tang HJ and Huang ZP performed the statistical analysis and participated in its design; Pan HL and Wei HY helped to draft the manuscript; all authors read and approved the final manuscript.
Informed consent statement: All participants provided written informed consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jing Bai, MD, Department of Respiratory Medicine, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. bj1312002@aliyun.com
Received: August 6, 2020
Peer-review started: August 4, 2020
First decision: August 21, 2020
Revised: September 25, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: December 26, 2020
Processing time: 135 Days and 1.9 Hours
Abstract
BACKGROUND

Pulmonary cryptococcosis (PC) is an invasive fungal disease caused mainly by Cryptococcus (C.) neoformans or C. gattii. It may be present in immunocompetent or immunocompromised patients. The radiographic features of PC vary, and the most common computed tomography manifestation is the presence of solitary or multiple pulmonary nodules or masses distributed in the outer zone of the lung field. The appearance of nodular or mass-like PC on computed tomography scans resembles that of primary or metastatic lung cancers, and differential diagnosis is sometimes difficult. The coexistence of PC and malignant tumors is rarely observed.

CASE SUMMARY

This paper reports three cases of PC combined with lung adenocarcinoma diagnosed by video-assisted thoracic surgery lung biopsy, which were successfully managed by early diagnosis and treatment.

CONCLUSION

The present case report might serve as a reminder not to neglect PC coexisting with adenocarcinoma. Early diagnosis and treatment lead to a better prognosis.

Keywords: Adenocarcinoma; Coexistence; Computed tomography; Pulmonary cryptococcosis; Respiratory medicine; Case report

Core Tip: The appearance of nodular or mass-like pulmonary cryptococcosis on computed tomography scans resembles that of primary or metastatic lung cancers, and differential diagnosis is sometimes difficult. To the best of our knowledge, the coexistence of pulmonary cryptococcosis and malignant tumors is rarely reported. However, the possibility of the coexistence of pulmonary cryptococcosis and adenocarcinoma indicates that the pathological results of one lesion cannot represent the characteristics of all lesions. In such cases, close follow-up and biopsy of multiple lesions may be required.