{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T06:11:45Z","timestamp":1777961505295,"version":"3.51.4"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Pulmonary sarcoidosis is an idiopathic granulomatous disorder primarily affecting the lungs and mediastinal lymph nodes. Pulmonary cryptococcosis, an opportunistic mycosis caused by\n                    <jats:italic>Cryptococcus<\/jats:italic>\n                    species, may occur concurrently with sarcoidosis, presenting substantial diagnostic challenges, particularly in treatment-na\u00efve patients. A 63-years-old previously healthy female presented with insidious-onset dyspnea and low-grade fever. Chest computed tomography (CT) showed mediastinal and hilar lymphadenopathy, accompanied by small nodules in the right lower lobe. She was diagnosed with pulmonary sarcoidosis at a local hospital and started on prednisone, with symptomatic improvement. However, follow-up imaging showed enlargement and cavitation of the right lower lobe nodules. Admission laboratory tests, including inflammatory markers and fungal serology, were all unremarkable. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) identified sequences of\n                    <jats:italic>Cryptococcus neoformans<\/jats:italic>\n                    . Histopathological examination of mediastinal lymph node specimens confirmed the presence of non-necrotizing granulomas, which is consistent with a diagnosis of sarcoidosis. Meanwhile, the right lower lobe lung biopsy revealed positive staining for\n                    <jats:italic>Cryptococcus<\/jats:italic>\n                    . The patient was treated with fluconazole, resulting in radiological resolution. This case highlights the importance of considering pulmonary cryptococcosis as a potential complication in treatment-na\u00efve sarcoidosis patients who present with abnormal chest shadows. Underlying immune dysregulation in sarcoidosis may obscure both clinical and radiological findings, thereby complicating the diagnostic process.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1822801","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:31:42Z","timestamp":1777959102000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary sarcoidosis complicated with pulmonary cryptococcosis: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Shixuan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunyan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking University First Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking University First Hospital","place":["Beijing, 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