Tuberc Respir Dis.  2014 Dec;77(6):266-270. 10.4046/trd.2014.77.6.266.

Pulmonary Cryptococcosis That Mimicked Rheumatoid Nodule in Rheumatoid Arthritis Lesion

Affiliations
  • 1Department of Internal Medicine, National Medical Center, Seoul, Korea. inajeong@gmail.com
  • 2Department of Pathology, National Medical Center, Seoul, Korea.
  • 3Department of Thoracic and Cardiovascular Surgery, National Medical Center, Seoul, Korea.

Abstract

Recently, the incidence of pulmonary cryptococcosis is gradually increasing in rheumatoid arthritis (RA) patients. Pulmonary rheumatoid nodules (PRN) are rare manifestations of RA. Eighteen months ago, a 65-year old woman was admitted to hospital due to multiple nodules (2.5x2.1x2 cm) with cavitations in the right lower lobe. She was diagnosed with RA three year ago. She had been taking methotrexate, leflunomide, and triamcinolone. A video-assisted thoracoscopic surgery biopsy was performed and PRN was diagnosed. However, a newly growing huge opacity with cavitation was detected in the same site. Pulmonary cryptococcal infection was diagnosed through a transthoracic computed tomograpy guided needle biopsy. Cryptococcus antigen was detected in serum but not in cerebrospinal fluid. The patient was treated with oral fluconazole which resulted clinical improvement and regression of the nodule on a series of radiography. Herein, we report the case of pulmonary cryptococcosis occurring in the same location as that of the PRN.

Keyword

Cryptococcus; Cryptococcosis; Rheumatoid Nodule; Arthritis, Rheumatoid

MeSH Terms

Arthritis, Rheumatoid*
Biopsy
Biopsy, Needle
Cerebrospinal Fluid
Cryptococcosis*
Cryptococcus
Female
Fluconazole
Humans
Incidence
Methotrexate
Radiography
Rheumatoid Nodule*
Thoracic Surgery, Video-Assisted
Triamcinolone
Fluconazole
Methotrexate
Triamcinolone
Full Text Links
  • TRD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr