Clinical and Computed Tomography Characteristics of Solitary Pulmonary Nodules Caused by Fungi: A Comparative Study

Figures & data

Table 1 Patients’ Clinical Characteristics

Characteristics	Patients with Fungal Nodules (n = 68)	Patients with Cancerous Nodules (n = 140)	P-value
Age (years)	51.2 ± 11.5	61.3 ± 10.2	0.000
Sex (male)	37 (54.4)	78 (55.7)	0.859
History of malignant tumor	7 (10.3)	10 (7.1)	0.436
Number of immunocompromised cases	30 (44.1)	25 (17.9)	0.000
Smoking history	19 (27.9)	59 (42.1)	0.047
Drinking history	18 (26.5)	41 (29.3)	0.673
Clinical symptoms	30 (44.1)	75 (53.6)	0.201

Note: Data are expressed as number (percentage) or mean ± standard deviation.

Table 2 CT Characteristics of the Fungal and Cancerous Nodules

Characteristics	Fungal Nodules (n = 68)	Cancerous Nodules (n = 140)	P-value
Size (cm)	1.5 ± 0.7	1.5 ± 0.6	0.696
Distribution			0.647
Upper lobe	41 (60.3)	89 (63.6)
Middle and lower lobe	27 (39.7)	51 (36.4)
ACS	22 (34.4)	0 (0.00)	0.000
Vacuole sign	6 (9.4)	7 (5.0)	0.380
HS	15 (23.4)	6 (4.3)	0.000
Annular and ill-defined HS	11 (73.3)	0 (0.00)	0.000
Annular and well-defined HS	1 (6.7)	0 (0.00)
Partial and well-defined HS	3 (20.0)	6 (100.0)
Air bronchogram	12 (18.8)	30 (21.4)	0.661
Type I	12 (100)	5 (16.7)	0.000
Type II	0	4 (13.3)
Type III	0	20 (66.7)
Type IV	0	1 (2.4)
Cavity	3 (4.7)	6 (4.3)	0.897
Satellite lesions	29 (45.3)	4 (2.9)	0.000
Lymph node enlargement	2 (2.9)	20 (14.3)	0.013
Plain CT value (HU)	33.7 ± 31.3	22.5 ± 20.8	0.014
Enhanced CT value (HU)	62.7 ± 30.9	62.8 ± 31.3	0.493
ΔCT value (HU)	29.0 ± 19.2	40.3 ± 28.3	0.038

Note: Data are expressed as number (percentage) or mean ± standard deviation.

Abbreviations: ACS, air crescent sign; HS, halo sign; ΔCT value, degree of enhancement.

Figure 1 A patient with pulmonary cryptococcosis. (A and B) axial CT images show a solid nodule located in the left upper lobe, there is a crescent-shaped collection of air and lower density in the periphery of this nodule (air crescent sign) (arrows). (B) on enhanced CT image, the nodule shows ring-like enhancement.

Figure 2 A patient with diabetes and pulmonary cryptococcosis. (A) axial and (B) minimum intensity projection images show a solid nodule located in the right lower lobe. There are multiple natural bronchi in it. (C) axial CT image shows that the nodule is surrounded by annular and ill-defined ground glass opacity (halo sign).

Figure 3 A patient with invasive adenocarcinoma. (A) axial and coronal (B) CT images show a solid nodule located in the right middle lobe, and there is partial and well-defined ground glass opacity (halo sign) in its periphery (arrow).

Figure 4 A patient with pulmonary cryptococcosis. (A) axial and (B) maximum intensity projection images show a solid nodule located in the right upper lobe. There are multiple scattered smaller nodules (satellite lesions, arrows) in the adjacent lung field.

Figure 5 A patient with a history of diabetes mellitus for 15 years and pulmonary aspergillus. (A and B) axial plain CT images show an oval and well-defined solid nodule located in the right lower lobe (CT value = 14HU). On enhanced CT image (C), it has no significant enhancement (CT value = 15HU).