Radiological features of AIDS complicated by pulmonary cryptococcosis: Literature review and a report of 10 cases

Purpose: To retrospectively analyze the clinical data and radiological features of AIDS complicated by pulmonary cryptococcosis (PC) for more knowledge about the condition and its diagnosis. Methods: A toal of 10 cases with AIDS complicated by pulmonary cryptococcosis was recruited as the subject of the study, and all the clinical and radiological data were collected. The patients included 6 males and 4 females, aged 40–58 years. The CD4+ T cell count was below 100/μl in 8 cases. All of them were pathologically or etiologically diagnosed with AIDS complicated by PC, and received digital radiography (DR) and CT examination. All the radiological images were retrospectively analyzed by two senior radiologists who knew nothing about the patients. Results: The radiological findings were categorized into 3 types: (1) multiple miliary nodules in 2 cases (20%), which distributed in bilateral lung apex and dorsal segment of lower lobe, being 2–3 mm∼2 cm in diameter, with “halo sign” around the larger lesion; (2) singular nodule or mass in 3 cases (30%), which was located in the peripheral region of lung, also with “halo sign” around the lesion; (3) cavity in 5 cases (50%), which was singular or multiple, with uneven thickness of the cavity wall and inner-wall nodule. In a few cases, enlarged mediastinal lymph node and pleural effusion accompanied. Conclusion: The radiological signs featured AIDS complicated by pulmonary cryptococcosis such as singular or multiple nodules with cavity and “halo sign” can facilitate its diagnosis. But the diagnosis should be made in combination to the clinical history