Pulmonary Cryptococcosis Mimicking Malignancy in Cancer Patients Diagnosed by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: Two Case Reports

模仿惡性腫之肺隱球菌於癌症病人經支氣管內視鏡超音波導引細針抽吸術診斷

沈宜成(Yi-Cheng Shen) ； 涂智彥(Chih-Yen Tu) ； 廖偉志(Wei-Chih Liao) ； 陳家弘(Chia-Hung Chen) ； 施純明(Chuen-Ming Shih) ； 徐武輝(Wu-Huei Hsu)

《胸腔醫學》 29卷6期 (2014/12) Pp. 351-357

摘要

在癌症患者中，肺結節常常被認為是轉移性惡性腫瘤或原發性肺腫瘤。我們在此報告兩位案例，一位為43歲女性病患患有乳腺癌，和一位56歲男性病患患有早期肺腺癌，他們的表現皆為沒有症狀的肺部結節。初步懷疑診斷為肺部轉移或腫瘤復發，他們接受微創診斷方法的支氣管內視鏡超音波導引細針抽吸（EBUS-TBNA）確定肺隱球菌感染的診斷。隨後，接受抗黴菌藥物的治療，患者恢復良好。我們証明在癌症患者區別肺隱球菌感染或癌症肺部轉移，並因此接受正確治療的重要性，以及利用支氣管內視鏡超音波導引細針抽吸術診斷肺隱球菌感染確實是安全及有效。

關鍵字

肺隱球菌 ； 支氣管內視鏡超音波 ； 支氣管內視鏡超音波導引細針抽吸術

並列摘要

In cancer patients, pulmonary nodules are often considered a metastatic disease or primary lung tumor. We report the cases of a 43-year-old woman with breast cancer and a 56-year-old man with early-stage lung adenocarcinoma, both of whom presented with asymptomatic pulmonary nodules. A presumptive diagnosis of pulmonary metastasis or tumor relapse was made, and they underwent endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) to establish the diagnosis of cryptococcal infection. Antifungal therapy was prescribed subsequently, and full recovery followed. We demonstrate the importance of differentiating between pulmonary cryptococcal infection and metastasis in cancer patients, and the safety and efficacy of TBNA in the diagnosis of pulmonary cryptococcosis.

並列關鍵字

pulmonary cryptococcosis ； endobronchial ultrasound-guided transbronchial needle aspiration