@article{oai:kanazawa-u.repo.nii.ac.jp:00055469,
 author = {Koyama, Kazunori and Matsumoto, Isao and Yoshida, Shunhei and Kakegawa, Seichi and Takemura, Hirofumi and 古山, 和憲 and 松本, 勲 and 吉田, 周平 and 懸川, 誠一 and 竹村, 博文},
 issue = {1},
 journal = {日本呼吸器外科学会雑誌, The journal of the Japanese association for chest surgery},
 month = {Jan},
 note = {症例は49歳，男性．髄膜炎様症状のため当院神経内科へ紹介となった．胸部CTで左肺上葉肺門部に大きさ2.1 cmの不整形結節を認め，気管支鏡検査を行ったが確定診断に至らなかった．肺癌も否定できない画像所見のため外科的肺生検目的に当科紹介となった．手術は左肺上葉切除術を施行し，病理学的診断で肺クリプトコッカス症と診断された．術前の髄液検査ではクリプトコッカス抗原，培養検査ともに陰性であったが，術前の保存血液検体からクリプトコッカス抗原が検出されたため，髄膜炎様症状もクリプトコッカス症に伴うものと考え，抗真菌薬による治療を行った．症状は速やかに改善し，術後2年の現在，再発なく経過している．肺クリプトコッカス症は画像所見だけでは鑑別が難しく，診断に難渋する場合が多いが，切除生検が診断に有用であると考えられた．, A 49-year-old man was admitted to the Department of Neurological and Internal Medicine of our hospital with mild fever and headache, suggestive of meningitis. Computed tomography (CT) showed an approximately 2.1-cm- diameter nodule in the hilum of the left lung. He underwent bronchoscopy, but no diagnosis was made. Because the CT image led to a suspicion of lung cancer, he was referred to our department for diagnosis by therapeutic resection. Left upper lobectomy was performed. Histopathological examination of the resected specimen resulted in a diagnosis of pulmonary cryptococcosis. His cerebrospinal fluid (CSF) was negative for cryptococcal antigen and Cryptococcus neoformans was not grown on mycological culture of the CSF. However, a preserved preoperative blood sample was positive for cryptococcal antigen. Thus, cryptococcal meningitis was diagnosed and he was treated with antifungal therapy, which resulted in marked improvement of his fever and headache. There was no recurrence during the following 2 years. It is difficult to diagnose pulmonary cryptococcosis because the imaging findings vary markedly. We present a patient with pulmonary cryptococcosis diagnosed by resection of the affected lobe of the lung., 金沢大学医薬保健研究域医学系},
 pages = {-52--57},
 title = {肺切除により診断に至った髄膜炎様症状を伴う肺クリプトコッカス症の1例},
 volume = {33},
 year = {2019}
}