分析免疫功能正常宿主患肺隐球菌病的临床症状及影像学特点，提高该病的早诊、早治率。

选择2006年1月至2018年10月空军军医大学唐都医院收治的经手术或活检后病理证实的47例免疫正常肺隐球菌病患者的临床资料，对其临床症状及影像学表现进行回顾性分析。

免疫功能正常的肺隐球菌病患者好发于40～60岁(85.10%)中老年人，临床症状无明显特异性，影像学表现主要包括单发结节肿块型(48.94%)，多发结节肿块型(19.15%)，肺炎型(23.40%)，混合型(6.38%)和不典型者(2.13%)。典型CT征象常伴"晕征"、"边缘平直征"、"胸膜凹陷征"、"细小毛刺征""蘑菇兄弟征"和"近端支气管充气征"；在单发结节肿块型、多发结节肿块型和肺炎型三者中，"晕征"、"边缘平直征"、"胸膜凹陷症"和"细小毛刺征"多见于前两者，三者比较差异有统计学意义(78.26%、66.67%、27.27%，P＝0.019；82.61%、77.78%、18.18%，P＝0.001；56.52%、44.44%、0%，P＝0.003；39.13%、33.33%、0%，P＝0.037)；"近端支气管充气征"多见于后者，三者比较差异有统计学意义(34.78%、33.33%、81.82%，P＝0.029)；"蘑菇兄弟征"主要见于多发结节肿块型(77.78%)。与HIV感染等免疫抑制宿主相比较，免疫功能正常宿主肺隐球菌病CT征象伴空洞和胸腔积液者少见。

免疫功能正常宿主肺隐球菌病临床症状无明显特异性，其影像学表现与HIV感染等免疫抑制宿主不尽相同，但易与肺炎、肺结核、肺癌等混淆，其中"晕征"、"蘑菇兄弟征"和"近端支气管充气征"具有一定特异性。

To evaluate the clinical manifestation and radiographic findings of pulmonary cryptococcosis in the immunocompetent patients in order to improve its early diagnosis and early treatment.

A total of 47 immunocompetent patients with pathologically-proven pulmonary cryptococcosis after surgery or biopsy admitted to Tangdu Hospital affiliated to Air Force Military Medical University from January 2006 to October 2018 were included. The patients′clinical symptoms and CT imaging features were reviewed retrospectively.

Pulmonary cryptococcosis occurred in the immunocompetent patients predominately in the middle-aged and elderly patients who were 40-60 years old (85.10%), but it had no specific clinical symptoms. The CT imaging features included single pulmonary nodule/mass (48.94%), multiple nodules/masses (19.15%), pneumonia-like infiltration(23.40%), mixed manifestations (6.38%), and atypical imaging features (2.13%). Typical CT imaging features were often accompanied by "halo sign" , "flat margin sign" , "pleural indentation sign" , "spicule sign" , "mushroom brother sign" , and "proximal air bronchogram sign" . Among the three types of radiographic features including single pulmonary nodule/mass, multiple nodules/masses and pneumonia, the "halo sign" , "flat sign" , "pleural indentation sign" and "spicule sign" were more common in the first two types, with statistical significant difference (78.26%, 66.67% and 27.27%, respectively, P=0.019; 82.61%, 77.78% and 18.18%, respectively, P=0.001; 56.52%, 44.44% and 0%, respectively, P=0.003; and 39.13%, 33.33% and 0%, respectively, P=0.037). The "proximal air bronchogram sign" was significantly more frequently observed in the pneumonia type (34.78%, 33.33% and 81.82%, P=0.029), while the "mushroom brothers sign" was predominantly observed in the multiple nodules/masses (77.78%).

Pulmonary cryptococcosis in the immunocompetent patients has no specific clinical symptoms. The chest imaging features of pulmonary cryptococcosis in the immunocompetent patients are different from the immunocompromised patients. However, they are often confused with pneumonia, tuberculosis, and lung cancer, etc. "Halo sign" , "mushroom brother sign" and "proximal air bronchogram sign" are relatively specific to the diagnosis of pulmonary cryptococcosis.