CAJ | 학술논문

目的：分析肺隐球菌病的临床特点、诊断、治疗及预后。方法回顾分析23例确诊肺隐球菌病患者的高危因素、临床表现、影像学特点、确诊方法及治疗转归。结果原发性肺隐球菌病21例（91.3％），继发性2例（8.7％），合并基础疾病5例（21.7％）。主要症状为咳嗽13例（56.5％）和胸痛9例（39.1％）。影像学主要表现为单发或多发结节/肿块18例（78.3％），主要分布在肺下叶（12例）。10例经皮穿刺肺活检确诊，12例经外科手术组织病理学确诊。行氟康唑治疗20例中（外科切除病灶10例），18例痊愈。结论原发性肺隐球菌病较为常见，影像学特点对诊断有一定的提示意义。经皮穿刺肺活检是经济、安全、有效的确诊措施，氟康唑治疗疗效较好。
목적：분석폐은구균병적림상특점、진단、치료급예후。방법회고분석23례학진폐은구균병환자적고위인소、림상표현、영상학특점、학진방법급치료전귀。결과원발성폐은구균병21례（91.3％），계발성2례（8.7％），합병기출질병5례（21.7％）。주요증상위해수13례（56.5％）화흉통9례（39.1％）。영상학주요표현위단발혹다발결절/종괴18례（78.3％），주요분포재폐하협（12례）。10례경피천자폐활검학진，12례경외과수술조직병이학학진。행불강서치료20례중（외과절제병조10례），18례전유。결론원발성폐은구균병교위상견，영상학특점대진단유일정적제시의의。경피천자폐활검시경제、안전、유효적학진조시，불강서치료료효교호。
Objective To investigate the clinical features , diagnosis, treatment and prognosis of pulmonary cryptococcosis.Methods The medical data of 23 cases of proven pulmonary cryptococcosis were studied retrospec-tively.Results Twenty-three cases were anti-HIV negative, 21 cases(91.3%) were primary pulmonary cryptococco-sis and 2 cases( 8.7%) were secondary ones .Cough(13 cases, 56.5%)and chest pain (9 cases, 39.1%) were the most common symptoms.Subpleural nodule/mass(18 cases, 78.3%) in the lower lobes(12 cases, 52.2%)were common radiologic findings .The definite diagnostic techniques included surgical lung biopsy (12 cases, 52.2%) and CT guided percutaneous lung biopsy (10 cases, 43.5%).Ten patients received surgical resection lesions and 10 in-ternal patients were treated with fluconazole and 18 cases were cured .Conclusion Primary pulmonary cryptococcosis also occurs frequently .Radiologic findings can provide the clue for diagnosing pulmonary cryptococcosis .CT guided percutaneous lung biopsy is the most costless and efficient diagnostic technique .Most pulmonary cryptococcosis pa-tients respond well to fluconazole .