Pulmonary cryptococcosis mimicking solitary lung cancer in an immunocompetent patient.

A 48-year-old Chinese male henhouse keeper was admitted with dyspnoea. A plain chest radiograph and CT scan indicated a solitary right lung mass with invasion to the trachea (fig 1A and B). Positron emission tomography with Ffluoro-2-deoxy-D-glucose (FDG-PET) showed accumulation in the lung mass (fig 1C). A transbronchial biopsy specimen provided a pathological diagnosis of pulmonary cryptococcosis (fig 2). There were no malignant cells in the specimen. A fungus culture grew Cryptococcus neoformans, but a study of the cerebrospinal fluid showed no evidence of cryptococcal meningitis. A serum HIV test was negative. The patient was treated with oral itraconazole 400 mg/day for 1 year without surgical intervention. A CT scan of the thorax after 2 years showed no evidence of the pulmonary lesion.