表现为肿瘤样阴影的肺念珠菌病

M. Babayiğit, N. Dereli, Zehra Baykal, Handan Güleç, Filiz Koç, M. Şahap, E. Horasanlı
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摘要

肺部真菌感染十分罕见,在重症患者中死亡风险很高。鉴别诊断需要进一步检查,包括放射成像。在本文中,我们介绍了一名在胸部 X 光片上有肿瘤样阴影,并且在首次胸部计算机断层扫描(CT)检查中发现 4 厘米轻度坏死软组织肿块的患者,该患者因此被预先诊断为肺癌。由于患者全身状况不佳,其家人没有接受进一步的癌症检查。大约 40 天后,患者因呼吸困难被送入重症监护室。支气管样本中的恶性细胞呈阴性,培养液中检测到热带念珠菌。在使用抗真菌药物治疗后,CT 对照组中肿块的大小有所减小。我们认为,CT 上的图像是由于热带念珠菌感染所致,并在抗真菌治疗后消退。总之,我们可以得出结论,肺念珠菌病可能会出现不典型的影像学表现。在肺癌的鉴别诊断中,如果出现令人困惑的肿块样影像,应注意真菌感染。
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Pulmonary candidiasis presenting as tumor-like shadow
Lung fungal infections are rare and carry a high risk of death in critically ill patients. Further investigations including radiological imaging are needed for differential diagnosis. In this article, we present a patient with a tumor-like shadow on chest X-ray and a mildly necrotic soft tissue mass of 4 cm in the first computed tomography (CT) examination of the thorax, who was therefore prediagnosed with Lung Cancer. Due to the poor general condition of the patient, his family did not accept further examinations for cancer. Approximately 40 days later, the patient was taken to the intensive care unit with the complaint of respiratory distress. The bronchial sample was negative for malignant cells and Candida Tropicalis was detected in cultures. The size of the mass decreased in CT controls after treatment with antifungal agents. We thought that the image on CT was due to Candida Tropicalis infection and regressed with antifungal treatment. In conclusion, we can conclude that pulmonary candidiasis may present with atypical radiological findings. Fungal infections should be kept in mind in the differential diagnosis of lung cancer in cases with confusing mass-like images.
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