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Cryptococcal Lymphadenitis and Massive Splenomegaly in an Immunocompromised Patient

Coskun, Zafer Ünsal MD*†; Mathews, Dana PhD, MD*; Weatherall, Paul MD*; Skiest, Daniel MD; Öz, Orhan K. MD, PhD*

doi: 10.1097/01.rlu.0000257201.95620.ba
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We report an unusual case of lymphadenitis and splenitis in a hemophiliac with AIDS. Splenomegaly without focal lesions was shown by CT and MRI. A Ga-67 scan demonstrated markedly increased activity in the spleen and increased focal activity in the left supraclavicular region. Cryptococcus neoformans was cultured from blood. A fine needle aspirate of a supraclavicular lymph node revealed budding yeast. After therapy, a repeat gallium scan showed no supraclavicular activity and markedly reduced splenic uptake. Cryptococcal infection should be in the differential diagnosis of markedly increased Ga-67 uptake in splenomegaly and focal lymph node uptake in an immunocompromised patient.

From the *Department of Radiology, UT Southwestern Medical Center, Dallas, TX; †Gülhane Military Medical Academy, Ankara, Turkey; and ‡Internal Medicine, Baystate Medical Center, Springfield, MA.

Received for publication September 21, 2006; accepted December 20, 2006.

Reprints: Orhan K. Öz, MD, PhD, Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9153. E-mail: orhan.oz@utsouthwestern.edu.

© 2007 Lippincott Williams & Wilkins, Inc.