Discussion

• Pulmonary cryptococcosis may appear with various patterns of lung lesions; however, localized to a lung lobe, especially single nodular lesion, is the most common abnormality in immunocompetent patient
• When lung lesions are present as nodules in immunocompetent patients, pulmonary cryptococcosis usually shows asymptomatic (or mild symptoms) and non-specific laboratory findings, particularly without apparently infection features, and may thus simulate a malignant tumors
• When lung lesions are present as consolidations in patients with pulmonary cryptococcosis, serum cryptococcal antigen test is more frequently positive, which may reflects the pathogen load or immune response

Conclusion

• Distinguishing pulmonary cryptococcosis in immunocompetent patients from malignancy remains challenging for radiologists

• A careful understanding of the imaging patterns and ancillary imaging features of pulmonary cryptococcosis in immunocompetent patients can lead to fewer lung resections of nonmalignant diseases as the first invasive procedure