TY - JOUR AU - Yang, Bumhee AU - Lee, Hyun AU - Lee, Taebum AU - Kim, Sun-Hyung AU - Kim, Min Young AU - Jeong, Byeong-Ho AU - Shin, Sumin AU - Kim, Seonwoo AU - Lee, Kyung Soo AU - Kwon, O. Jung AU - Kim, Hojoong PY - 2019 TI - The use of surgery in a real-world clinic to diagnose and treat pulmonary cryptococcosis in immunocompetent patients JF - Journal of Thoracic Disease; Vol 11, No 4 (April 30, 2019): Journal of Thoracic Disease Y2 - 2019 KW - N2 - Background: We evaluated the role played by surgery in the diagnosis and treatment of pulmonary cryptococcosis (PC) in immunocompetent subjects. Methods: We retrospectively studied 53 immunocompetent patients who were pathologically diagnosed with PC between January 2000 and December 2016 in a tertiary referral center. We compared the radiological presentations of, and diagnostic modalities used to evaluate, patients diagnosed both surgically and non-surgically. We also compared the treatment outcomes of patients who underwent surgical resection alone and those who received additional antifungals following surgical resection. Results: Of the 53 patients, 30 (57%) were diagnosed via non-surgical modalities including percutaneous needle biopsy (PCNB) (n=29) and transbronchial lung biopsy (TBLB) (n=1); and 23 (43%) were diagnosed by surgical modalities including video-assisted thoracoscopic wedge resection (n=22) and lobectomy (n=1). An initial clinical suspicion of a lung malignancy was associated with the use of surgical diagnostic approaches (P vs . 73%; P=0.007). However, there was no significant difference in disease progression between patients who underwent surgical resection alone and those who additionally received antifungals (P=0.999). Conclusions: Surgical resection was required in some patients to diagnose PC. An initial suspicion of a lung malignancy was associated with use of surgical diagnostic approaches. Surgical resection not only afforded reliable diagnoses but also effectively treated PC. There was no need for additional antifungals after complete surgical resection. UR - https://jtd.amegroups.org/article/view/28416