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首页> 外文期刊>Journal of neurology >Intracerebral mass lesion diagnosed as cryptococcoma in a patient with sarcoidosis, a rare opportunistic manifestation induced by immunosuppression with corticosteroids
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Intracerebral mass lesion diagnosed as cryptococcoma in a patient with sarcoidosis, a rare opportunistic manifestation induced by immunosuppression with corticosteroids

机译：结节病患者被诊断为隐球菌病的脑内肿块病变，这是皮质类固醇免疫抑制诱导的罕见机会性表现

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摘要

Cryptococcal infection of the central nervous system (CNS) typically affects patients with HIV infection. In addition, opportunistic infections can also occur during immunosuppressive therapies. Some patients develop cryptococcal meningitis. Cryptococcomas, however, are rarely observed. A 42-year-old patient with sarcoidosis known for 2- years presented with a cerebral mass lesion primarily thought to be CNS sarcoidosis. Stereotactic biopsy and extensive micro- and macrobiological investigations revealed a cryptococcoma which had emerged from cryptococcal meningitis despite 3 months of treatment. Differential diagnosis of cerebral cryptococcoma is difficult due to the unspecific findings in the CSF analysis if C. neoformans fails to be detected using Indian ink staining or PCR studies. In this case, stereotactic biopsy and pathohistological examination revealed C. neoformans causing intracerebral mass lesion. Intensive treatment with antifungal drugs was followed by remission of all symptoms. In conclusion, cryptococcoma of the CNS represents a very important indication of mass lesions in patients suffering from sarcoidosis and treated with corticosteroids.
机译：中枢神经系统（CNS）的隐球菌感染通常会影响HIV感染患者。另外，在免疫抑制疗法期间也可能发生机会性感染。一些患者发生隐球菌性脑膜炎。然而，隐球菌很少见。一名已知2年的42岁结节病患者出现了主要被认为是CNS结节病的脑块病变。立体定向活检和广泛的微生物和宏观生物学研究表明，尽管治疗了3个月，但隐球菌性脑膜炎仍出现了隐球菌。如果不能通过印度墨水染色或PCR研究检测到新产梭状芽胞杆菌，则由于CSF分析中的非特异性发现，很难对脑隐球菌进行鉴别诊断。在这种情况下，立体定向活检和病理组织学检查显示新孢子虫引起脑内块状病变。用抗真菌药进行强化治疗后，所有症状均缓解。总之，中枢神经系统隐球菌瘤是结节病并接受皮质类固醇激素治疗的患者大量病变的重要指标。

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