1997 Volume 11 Issue 5 Pages 651-654
We report a case of lung cryptococcosis in a post-renal transplant patient. Thoracoscopic operation was very beneficial for making a diagnosis and treatment in this case.
A 49-year-old man, who had received a renal transplant two years previously and was being given immunosuppressive agents, was admitted to our hospital because of a chest abnormal shadow. No remarkable physical findings were found except for the abdominal operaion scar of the renal transplant. The values of laboratory data were unremarkable. Chest rentogenogram showed a well-defined nodular shadow in the right middle lung field. CT scan demonstrated a well-defined mass, about 3 cm in diameter, in the peripheral region of rt. S2. The definite diagnosis could not be obtained by fiberoptic bronchoscopy and other examinations. The immunosuppressive agents were administered just before the operation. Thoracoscopic tumor resection was performed and we made a diagnosis of cryptococcosis by its frozen section. After operation he was administered fiuconazole. The postoperative course was uneventful, with a hospital discharge on day 10. The blood cyclosporine level varied within the therapeutic range. Pathologically the surgical specimen showed the tumor consisting of necrotic tissue surrounding with infiltration of lymphocytes, and numerous capules appearing as an unstained halo. Many capsules were seen as a clear space with the Grocott's staining.
It was very beneficial for immunocompromised patients after renal transplantation to undergo thoracoscopic operation for diagnosis and treatment of lung nodular shadows.
