CTICasesCryptococcosis
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Imaging findings
A young woman with type 1 diabetes presented with chest pain. Initial chest radiograph showed consolidation in the superior segment of the right lower lobe, with a spine sign on lateral view. Follow-up CT revealed multiple areas of consolidation, thin-walled cavities, and smaller nodules, with a mass-like area corresponding to the radiograph. This was diagnosed as Cryptococcus based on antigen testing, with no CNS involvement.
Key takeaways
Cryptococcal pneumonia can present with large nodules or masses, sometimes cavitary, and areas of consolidation. While often seen in immunocompromised individuals, it can occur in those with milder immunosuppression (e.g., poorly controlled diabetes). It can mimic other fungal infections like blastomycosis. Diagnosis is typically made via culture or antigen testing, and CNS involvement should be excluded.
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