Liver cryptococcosis manifesting as obstructive jaundice in a young immunocompetent man: Report of a case

Satoshi Nara, Tsuyoshi Sano, Hidenori Ojima, Hiroaki Onaya, Masafumi Ikeda, Chigusa Morizane, Minoru Esaki, Yoshihiro Sakamoto, Kazuaki Shimada, Tomoo Kosuge

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

A 25-year-old immunocompetent Japanese man was referred to us for investigation and treatment of obstructive jaundice. Computed tomography (CT) showed dilatation of the bilateral intrahepatic bile ducts and a low-attenuated mass extending along the portal tract, from the hepatic hilum to the periphery, suggestive of cholangiocellular carcinoma (CCC) with periductal infiltration. However, the culture of bile obtained by percutaneous transhepatic biliary drainage revealed Cryptococcus neoformans. Microscopic examination of a biopsy specimen of the mass-like lesion in the liver revealed fungal organisms encapsulated in multinucleated giant cells. A small area of infiltration in the left lung was also detected on chest CT, and a diagnosis of liver and lung cryptococcosis was made. After 8 months of antifungal therapy, both the liver and lung lesions had vanished and the biliary stricture resolved. Unnecessary surgical intervention was avoided by an early and accurate diagnosis and effective antifungal therapy. The bile culture was the key to the definitive diagnosis in this case.

Original languageEnglish
Pages (from-to)271-274
Number of pages4
JournalSurgery Today
Volume38
Issue number3
DOIs
Publication statusPublished - 2008 Mar
Externally publishedYes

Fingerprint

Cryptococcosis
Obstructive Jaundice
Liver
Bile
Lung
Tomography
Intrahepatic Bile Ducts
Cryptococcus neoformans
Cholangiocarcinoma
Giant Cells
Early Diagnosis
Dilatation
Drainage
Pathologic Constriction
Thorax
Therapeutics
Biopsy

Keywords

  • Cholangio-cellular carcinoma
  • Cryptococcus
  • Jaundice
  • Liver

ASJC Scopus subject areas

  • Surgery

Cite this

Liver cryptococcosis manifesting as obstructive jaundice in a young immunocompetent man : Report of a case. / Nara, Satoshi; Sano, Tsuyoshi; Ojima, Hidenori; Onaya, Hiroaki; Ikeda, Masafumi; Morizane, Chigusa; Esaki, Minoru; Sakamoto, Yoshihiro; Shimada, Kazuaki; Kosuge, Tomoo.

In: Surgery Today, Vol. 38, No. 3, 03.2008, p. 271-274.

Research output: Contribution to journalArticle

Nara, S, Sano, T, Ojima, H, Onaya, H, Ikeda, M, Morizane, C, Esaki, M, Sakamoto, Y, Shimada, K & Kosuge, T 2008, 'Liver cryptococcosis manifesting as obstructive jaundice in a young immunocompetent man: Report of a case', Surgery Today, vol. 38, no. 3, pp. 271-274. https://doi.org/10.1007/s00595-007-3605-6
Nara, Satoshi ; Sano, Tsuyoshi ; Ojima, Hidenori ; Onaya, Hiroaki ; Ikeda, Masafumi ; Morizane, Chigusa ; Esaki, Minoru ; Sakamoto, Yoshihiro ; Shimada, Kazuaki ; Kosuge, Tomoo. / Liver cryptococcosis manifesting as obstructive jaundice in a young immunocompetent man : Report of a case. In: Surgery Today. 2008 ; Vol. 38, No. 3. pp. 271-274.
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