• Xinchao Zhang, Yujing Hu, Congna Tian, Qiang Wei, and Yanzhu Bian.
• Department of Nuclear Medicine, Hebei General Hospital, Shijiazhuang, China.
• Medicine (Baltimore). 2022 Oct 28; 101 (43): e31374e31374.

RationaleDisseminated cryptococcosis is extremely rare and is easily misdiagnosed as a malignant lymphoma. 18F-Fluorodeoxyglucose Positron Emission Tomography (PET)/ computed tomography (CT) may be useful to assess the involvement of disseminated cryptococcosis and to evaluate residual disease after treatment.Patient ConcernsA 21-years-old man presented with fever and cough for a month, with multiple red nodules scattered on the skin. 18F- Fluorodeoxyglucose PET/CT revealed multiple hypermetabolic lymph nodes in the upper and lower parts of the diaphragmatic region and hypermetabolic nodules in the skin. According to the PET/CT results, malignant lymphoma was considered a possibility, especially T-cell lymphoma involving the skin.DiagnosisCryptococcosis was diagnosed using inguinal lymph node biopsy and blood culture.InterventionsThe patient received two months of amphotericin B, fluconazole, and half a month of meropenem.OutcomesThe patient's body temperature returned to normal and the red nodules on the skin disappeared. Most of the hypermetabolic enlarged lymph nodes disappeared, which was confirmed by reexamination with PET/CT.LessonsDisseminated cryptococcosis is easily misdiagnosed as malignant lymphoma, especially when the lymph nodes are more involved. When multiple hypermetabolic enlarged lymph nodes appear on PET/CT, except for lymphoma, specific infections should also be considered.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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