分析结节肿块型肺隐球菌病(PC)的临床表现及CT特征，提高对该型PC的诊断准确性。

回顾性分析我院2011年8月至2020年1月确诊的18例结节肿块型肺隐球菌病的临床及影像学资料，其中经手术病理证实13例，穿刺病理证实5例。18例病例均有较完整的临床资料，且均完成CT平扫，5例完成CT增强扫描。对比分析患者CT影像学特征，包括病灶数量、形态、大小、分布、密度及增强特点。

18例患者均无明确鸽粪接触史，均为人类免疫缺陷病毒(HIV)阴性患者。14例免疫功能正常，4例免疫功能低下，其中3例患有2型糖尿病，1例确诊肺癌1年。11例患者无临床症状，体检偶然发现，2例患者以咳嗽就诊，1例患者以胸闷1年就诊。4例免疫功能低下患者常规肺CT检查发现。男性11例，女性7例。发病年龄为27~79岁，平均年龄(45.9±12.6)岁，以中、青年男性多见。右肺11例，左肺7例。单发结节型15例，多发结节型3例，结节共28个。病变以胸膜下分布为主，大小在2.5 cm内，13例可见晕征，10例可见支气管充气征；多发者可呈结节样融合，1例见蘑菇兄弟征。CT增强扫描显示结节均呈轻中度延迟强化。

PC以中、青年男性多见，临床症状轻；病变以右肺多见，倾向分布于肺野外带及胸膜下，晕征、支气管充气征和蘑菇兄弟征等CT表现有一定特征性。

To analyze the clinical characteristics and CT manifestations of pulmonary cryptococcosis (PC) with nodule and mass, and to explore its characteristic signs, so as to improve the diagnostic accuracy of PC.

The clinical and imaging data of 18 cases of pulmonary cryptococcosis with nodal mass confirmed in our hospital from August 2011 to January 2020 were analyzed retrospectively, including 13 cases confirmed by operation and pathology, 5 cases confirmed by puncture pathology. 18 cases had complete clinical data, and all completed CT plain scan, 5 cases completed CT enhanced scan. The CT imaging features of patients were analyzed, including the number, shape, size, distribution, density and enhancement of lesions.

None of the 18 patients had a clear history of pigeon fecal contact, and all of them were HIV negative. 14 cases had normal immune function, 4 cases had low immune function, 3 cases had type 2 diabetes, 1 case had lung cancer for one year. 11 patients had no clinical symptoms, but they were found by chance in physical examination, 2 patients were treated with cough, 1 patient with chest distress for one year. Four patients with hypoimmunity were found by routine lung CT. There were 11 males and 7 females. The age of onset was from 27 to 79 years old, with an average age of (45.9±12.6)years. There were 11 cases of right lung and 7 cases of left lung. There were 15 cases of single nodule type and 3 cases of multiple nodule type. The lesions were mainly subpleural distribution, the size was within 2.5 cm, halo sign was seen in 13 cases, bronchi inflation sign was seen in 10 cases, nodular fusion was seen in multiple cases, and mushroom brothers sign was seen in 1 case. CT enhanced scan showed that all the nodules showed mild to moderate delayed enhancement.

PC is more common in young and middle-aged men, with mild clinical symptoms, and more common in the right lung. PC tends to be distributed in the lung field and under the pleura. CT manifestations such as halo sign, bronchi inflation sign and mushroom brothers sign have certain characteristics.