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differential diagnosis with infection, infarction, and ab-
scess should be performed. The use of PET/CT has an
indeterminate finding, because both malignancies such as
infection and inflammation are often hypermetabolic.
These findings cause many false positives in endemic
areas [5]. Surgical treatment should not be the first op-
tion in cases of cryptococcal infection. However, when it
does not respond adequately to drug therapy, a resection
of the lesion (usually a lobectomy) should be performed.
by ultrasound.
Diagnostic option was surgical resection of the tumor
which, under direct visualization, had hardened aspect
and was adhered to the chest wall and diaphragm. A
lobectomy was performed. The pathological analysis was
positive for cryptococcal infection (Figur e 4).
3. DISCUSSION
Cryptococcal infection presents an increased preva-
lence in patients with immunosuppression of T cells. The
male is the most affected. In patients with HIV, the ra-
diological pattern is a predomin ant interstitial infiltration,
alveolar infiltrates, mixed infiltrate and pleural effusion.
A less common finding is excavation. Immunocompetent
individuals, such as the patient in question, present with
nodular lesions or masses [1,4]. Other cases of immuno-
competent patients reported in the literature showed the
same image aspect, however, clinical history was vari-
able [4,6,7].
This report reinforces the importance of pseudotu-
moral lesions for the differential diagnosis of lung
masses by radiologists, pulmonologists and oncologists.
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Figure 4. (A) Histological examination with hematoxylin and
eosin showed the presence of spore (arrow). (B) Mucicarmine
staining (arrow) confirmed the diagnosis of Cryptococcus.