Mass-forming hepatic cryptococcosis: a mimicker of metastatic tumors

This report provides the first imaging report of isolated intrahepatic cryptococcosis. An 83-year-old man was incidentally pointed out of hepatic nodules. CT revealed four well-defined nodules of 21 mm, 15 mm, 7 mm, and 5 mm in diameter without contrast enhancement. Two nodules displayed central hyperattenuation and the others were totally hyperattenuating. MRI showed that the nodules were hypointense relative to normal liver parenchyma on T1- and T2-weighted images. 18F-FDG PET imaging revealed no obvious increased uptake of nuclear species into the liver nodules. Partial resection of the three largest hepatic nodules was performed based on a preoperative diagnosis of hepatic metastasis from known sigmoid colon cancer. All three resected nodules were composed mainly of necrotic tissue with peripheral histiocytic aggregates and numerous yeast-like cells. The final diagnosis was hepatic cryptococcosis.