A Cryptic Incidental Finding of Cryptococcus Lymphadenitis

Abstract Cryptococcus species, particularly C. gattii and C. neoformans , are opportunistic pathogens typically affecting immunocompromised individuals, although cases in immunocompetent patients are increasingly recognized. We report the incidental discovery of cryptococcal lymphadenitis in a hepatic artery lymph node during cancer staging. Differential diagnoses for periportal lymphadenopathy include both malignant and infectious processes, with the presence of necrotizing granulomas narrowing the differential further. This case underscores the importance of considering Cryptococcus in the differential diagnosis of lymphadenopathy, even with a negative cryptococcal antigen and an immunocompetent patient, as early detection and treatment are critical to preventing serious complications.