Current medical imaging · 2026
Recurrent Pulmonary Nodules, from Pulmonary Cryptococcosis to ANCAAssociated Vasculitis: A Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhu Xingxing, Wu Xiaohong, Sun Yahong, Wu Shengjie, Zeng Jilin, Liu Zhihao, Zheng Jing, He Qifan
Аннотация
INTRODUCTION: On chest Computed Tomography (CT), pulmonary cryptococcosis and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) can both present as multiple non-cavitating pulmonary nodules. As a result, when such nodules worsen during antifungal therapy in a patient with pulmonary cryptococcosis, it is difficult to determine whether this represents progression of the infection or the development of concomitant AAV, posing a significant diagnostic challenge.
CASE PRESENTATION: A 67-year-old man presented with multiple non-cavitating pulmonary nodules and was diagnosed with pulmonary cryptococcosis. He completed a full course of antifungal therapy with clinical and radiologic improvement, and treatment was discontinued. After stopping therapy, he relapsed with the same pattern of multiple non-cavitating pulmonary nodules. Restarting antifungal therapy led to regression of the lesions. Unexpectedly, during antifungal maintenance therapy, he again developed multiple non-cavitating pulmonary nodules. Laboratory testing showed positivity for myeloperoxidase (MPO) and perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA), supporting a diagnosis of microscopic polyangiitis (MPA), a subtype of AAV. After discontinuation of antifungal therapy and treatment with prednisone plus mycophenolate mofetil, the pulmonary nodules showed marked regression.
CONCLUSION: Multiple non-cavitating pulmonary nodules can be an atypical presentation of MPA and overlap radiologically with pulmonary cryptococcosis. Accurate differentiation should integrate ANCA serology with careful assessment for involvement of other organ systems.
CASE PRESENTATION: A 67-year-old man presented with multiple non-cavitating pulmonary nodules and was diagnosed with pulmonary cryptococcosis. He completed a full course of antifungal therapy with clinical and radiologic improvement, and treatment was discontinued. After stopping therapy, he relapsed with the same pattern of multiple non-cavitating pulmonary nodules. Restarting antifungal therapy led to regression of the lesions. Unexpectedly, during antifungal maintenance therapy, he again developed multiple non-cavitating pulmonary nodules. Laboratory testing showed positivity for myeloperoxidase (MPO) and perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA), supporting a diagnosis of microscopic polyangiitis (MPA), a subtype of AAV. After discontinuation of antifungal therapy and treatment with prednisone plus mycophenolate mofetil, the pulmonary nodules showed marked regression.
CONCLUSION: Multiple non-cavitating pulmonary nodules can be an atypical presentation of MPA and overlap radiologically with pulmonary cryptococcosis. Accurate differentiation should integrate ANCA serology with careful assessment for involvement of other organ systems.