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目的:了解免疫功能正常的原发性肺隐球菌病患者的临床特征。方法:回顾性分析浙江省人民医院2018年1月至2020年2月诊断为肺隐球菌病且免疫功能正常患者的相关资料，包括年龄、性别、临床症状、影像学表现、实验室检查结果[包括血常规、C反应蛋白（CRP），血沉和生化指标等]、诊断方法及治疗转归情况。结果:共纳入免疫功能正常的原发性肺隐球菌病患者18例，男性13例，女性5例。所有患者均无鸽粪接触史。18例患者中，有轻微临床症状者10例，无临床症状者8例。胸部CT显示结节型12例，高密度影（炎症考虑）3例，团块影（肿瘤考虑）、薄壁空洞、胸膜病变各1例。单发病灶较多有15例。除2例患者CRP稍高，其余患者血常规、CRP、血沉均在正常范围内。所有患者痰培养均为阴性。患者经皮肺穿刺确诊4例，经手术病理诊断3例，临床诊断11例（包括经肺泡灌洗液培养出隐球菌5例，肺泡灌洗液隐球菌荚膜抗原阳性5例，血隐球菌荚膜抗原阳性1例）。15例患者服用氟康唑，复查CT后病灶吸收；3例患者经手术局部切除病灶，复查CT未见复发。结论:免疫功能正常的肺隐球菌病患者多无明显临床症状，影像学表现多以结节影为主，肺泡灌洗液培养和抗原检测是诊断肺隐球菌病的有效手段，若情况许可，应尽可能行支气管镜检查及肺泡灌洗液培养及抗原检测，规范合理治疗其预后良好。“,”Objective:To analyze the clinical features of primary pulmonary cryptococcosis in patients with normal immune function.Methods:Clinical data of patients confirmed with pulmonary cryptococcosis and with normal immune function was collected and retrospectively analyzed in Zhejiang Provincial People's Hospital from January 2018 to February 2020, including their age, gender, clinical symptoms, imaging findings, laboratory findings[blood routine, C-reactive protein (CRP) , erythrocyte sedimentation rate, biochemical markers, etc.], diagnostic method, treatment and outcomes.Results:There were 18 cases of primary pulmonary cryptococcosis with normal immune function enrolled including 13 males and 5 females. None of the patients had the exposure history to pigeon feces. Ten cases presented mild clinical symptoms and 8 had no clinical symptoms. Chest CT showed that 12 cases had nodular mass lesions, 3 had high density shadow (inflammatory considerations) , 1 had mass shadow (tumor consideration) , 1 had thin-wall hollow and 1 had pleural lesions. There were 15 cases with single lesions. Laboratory test showed that except for 2 patients with slightly higher CRP, blood routine examination, CRP and erythrocyte sedimentation rate were all within the normal range in the rest of patients. Sputum culture was negative in all patients. Four cases were confirmed by percutaneous lung biopsy, 3 cases by surgical and pathological diagnosis, and 11 cases by clinical diagnosis (5 cases were positive for n Cryptococcus cultured in alveolar lavage fluid, 5 cases were positive for glucuronoxylomannan in alveolar lavage fluid, and 1 case was positive for glucuronoxylomannan in blood) . Fifteen patients received fluconazole and the lesions were absorbed after CT reexamination. Three patients accepted local resection of the lesion, and no recurrence was found in the CT reexamination.n Conclusions:Patients of primary pulmonary cryptococcosis with normal immune function often show asymptomatic, and the imaging manifestations are mainly nodules. Alveolar lavage fluid culture and antigen detection are effective methods for the diagnosis of pulmonary cryptococcosis. If conditions permit, bronchoscopy, alveolar lavage fluid culture and antigen detection should be carried out as far as possible, and the reasonable and standardized treatment has a good prognosis.