What question did this study set out to answer?

To evaluate the role of 18F-FDG PET/CT in differentiating disseminated cryptococcosis from malignancies.

February 19, 2026Clinical Nuclear Medicine0 citations

18F-FDG PET/CT in Disseminated Cryptococcosis Mimicking Malignancy With Rib Osteolysis and Chest Wall Invasion

AMAparna MahalikAll India Institute of Medical Sciences NKNivedita KunduInstitute for Ethnic Studies GLGoriparti LalithaInstitute for Ethnic Studies

Key Points

To evaluate the role of 18F-FDG PET/CT in differentiating disseminated cryptococcosis from malignancies.
Case report of a 56-year-old male with disseminated cryptococcosis
Performed 18F-FDG PET/CT for treatment response evaluation
Monitored for metabolic changes in lesions over time
Imaging showed FDG-avid pleural-based mass with rib destruction and chest wall invasion
Interval imaging indicated metabolic regression of adrenal and pulmonary lesions
Findings emphasized the diagnostic challenges posed by cryptococcosis mimicking malignancy

Abstract

Disseminated cryptococcosis is a rare systemic fungal infection that can mimic thoracic malignancies. We report a 56-year-old man with known cryptococcosis on antifungal therapy who underwent 18 F-FDG PET/CT for response evaluation. Imaging revealed a heterogeneously FDG-avid pleural-based right upper lobe mass with lytic destruction of the first and second ribs and extension into chest wall musculature, with pulmonary nodules and nodal disease. Interval imaging demonstrated metabolic regression of adrenal and pulmonary lesions. This case highlights the diagnostic challenge of cryptococcosis presenting as an aggressive pseudotumor and underscores the utility of 18 F-FDG PET/CT in disease characterization and therapeutic monitoring.

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