Comparative Study On Clinical Characteristics Of Solitary Nodular Pulmonary Cryptococcosis And Lung Cancer

Objective: Pulmonary cryptococcosis is a deep fungus disease,especially solitary nodular pulmonary cryptococcosis,which is often misdiagnosed as lung cancer or other diseases in clinical work,which can not be treated in time and even lead to disputes between doctors and patients.The objective of this study was to observe and record the clinical characteristics of solitary nodular pulmonary cryptococcosis misdiagnosed as lung cancer,and to compare the clinical characteristics with the lung cancer,so as to provide help for clinical differentiation.Methods: A total of 59 patients with isolated nodular pulmonary cryptococcosis or peripheral pulmonary adenocarcinoma were selected from thoracic surgery department of Shengjing Hospital Affiliated to China Medical University from January 2015 to August 2022 according to inclusion and exclusion criteria.General data,clinical symptoms,underlying diseases,and imaging findings of the two groups were compared.To investigate the difference of clinical features between solitary nodular pulmonary cryptococcosis and lung adenocarcinoma.Results:Among the patients with Cryptococcus pneumoniae,18 cases were males and 11 cases were females,with an average age of 52.0±11.3 years old.Among them,15 cases were complicated with underlying diseases,and hypertension was common.18 cases had clinical symptoms,cough was common.The imaging manifestations were lobulation,halo sign and burr.Among the patients with lung cancer,there were16 males and 14 females,with an average age of 56.0±10.0 years old.Among them,12 patients were complicated with basic diseases,and hypertension was common.18 cases had clinical symptoms,mostly chest tightness.Radiographic findings include clear boundaries,lobulation,and burrs.By comparing the data of the two groups,the lesions of patients with pulmonary cryptococcus were distributed in the lower lobe of the right lung,showing a significantly higher solid focus than that of patients with pulmonary adenocarcinoma;the lesions were distributed in the upper lobe of the left lung,showing a lobular sign with clear nodular edges;the mixed solid focus was significantly lower than that of patients with pulmonary adenocarcinoma,with statistical significance(P < 0.05).Conclusion:It can be found from the current research results that isolated nodular pulmonary cryptococcosis mainly distributes in the peripheral zone of the lung,which is more common in the lower lobe of the right lung compared with lung cancer.Compared with lung cancer,the imaging findings were less lobulated,mostly with unclear edges and mostly solid nodules.