2007 Volume 21 Issue 1 Pages 80-84
We report a case of pulmonary cryptococcosis in a renal transplant recipient. A 53-year-old woman with living kidney transplantation had been receiving immunosuppressive therapy with tacrolimus and methylprednisolone. During a regular checkup, a nodular shadow was detected on her chest X-ray film. The chest CT scan revealed a solid nodule in the region of rt. S2 and showed a slightly increased diameter during follow-up. FDG-PET demonstrated an accumulation corresponding to the lesion with an SUV of 3.7 at 60min and 4.2 at 120min post-injection, indicating a possible malignancy. The nodule was resected under video-assisted thoracoscopic surgery and a diagnosis of pulmonary cryptococcosis was obtained. It is sometimes difficult to distinguish lung cancer from pulmonary cryptococcosis because pulmonary cryptococcosis often shows similar image characteristics to lung cancer. In this case, the increased diameter and positive accumulation on FDG-PET suggested malignancy rather than inflammation. Careful differentiation between malignancy and inflammation are necessary in post-transplant patients with abnormal chest shadows.
