本文旨在通过研究社区获得性肺隐球菌病的临床特点，提高医务人员对肺隐球菌病的认识，做到早期诊断和治疗。采用回顾性病例分析研究，统计2003 年1 月~2009 年12 月入住复旦大学附属中山医院的 55例确诊及临床诊断为肺隐球菌病患者的临床资料。55 例患者中，男性34 例，女性21 例;年龄17~75 岁，平均(44.8 ± 13.4) 岁。69.1 %无明显基础疾病。38.2% 无症状，因体检发现肺部阴影而就诊。6 1. 8% 有以下症状:咳嗽、咳痰，胸闷，发热，胸痛;症状轻，体征不明显，偶有肺部湿眼音。影像学表现:53.0% 表现为单发和 (或)多发结节肿块影， 3 1. 4% 表现为渗出实变影， 15.7% 为混合病灶。实验室检查:25 例患者行隐球菌乳胶凝集试验检查，阳性率100% 。痰真菌培养、活检组织培养和气管镜吸出物培养分别见新生隐球菌1 例、41 例和2 例。组织病理学检查:主要表现为肉芽肿性病变，多核巨细胞内、外见隐球菌孢子;过腆酸-雪夫染色细胞壁呈红色，阳性率为88. 5 % ; Grocott 六胺银染色细胞壁呈银黑色，阳性率为88.5% 。结果提示，社区获得性肺隐球菌病多见于中年男性，临床症状轻微，影像学表现多样，病理学及相应病原学、血清学检查有较高的诊断价值。

To investigate the clinical characteristics of community-acquired pulmonary cryptococcosis, a total of 55 cases of pulmonary cryptococcosis diagnosed at Zhongshan Hospital, Fudan University from 2003 to 2009 were retrospectively analyzed. The patients were consisted of 34 males and 21 females , with median age of 44.8±13.4 (17 to 75) years , 69.1 % of whom had no underlying diseases. Among those patients, 38.2% were asymptomatic, and 61. 8% had respiratory and (or) constitutional symptoms. The common symptoms were cough/ expectoration, fever , chest pain , and dyspnea on exertion. The common computed tomography (CT) scan patterns were nodule and mass, either solitary or multiple (53.0%) , infiltration and consolidation (31. 4 %), or diffused and mixed lesions (15. 7%). Twenty-five patients underwent latex agglutination test for pulmonary cryptococcosis, and 100% were positive. Cryptococcus neoformans was found in four biopsy tissue smears, in one sputum culture , and in two bronchoscopic lavage fluid cultures Non-caseous granuloma was the main characteristic in pathological study, with multinucleated giant cells containing abundant vacuolus yeast forms shown by periodic acid-Schiff (PAS) reaction and/ or GrocottGomori' s methenamine silver (GMS) staining. In conclusion, community-acquired pulmonary cryptococcosis is more prevalent in middle-aged male patients, the symptoms are mild, and the imaging patterns are multiple. Pathological, etiological, and serological examinations are valuable diagnostic tools.