Smear morphology of cryptococcosis presenting as a subcutaneous swelling in healthy adults: a report of three cases

Abstract

Our brief article highlights the morphological spectrum on FNAC smears and diagnostic problems faced in these uncommon circumstances where the aspirates were purulent and the yeasts were small, few and thin walled. In the acute inflammatory smear with occasional giant cells and/or granulomas special stains like PAS or Mucicarmine are necessary to look for budding yeast of Cryptococcus with thin neck.

Spectrum of fungal and parasitic infections on fine needle aspiration cytology

“…The background inflammatory response helped in some of the cases as we noted that aspergillous mostly had a necrotising granulomatous inflammation where as mucormyosis had a predominantly necrotizing background. Cryptococcus is known to occur in immunocompromised hosts but they can also occur in patients with normal immunity as shown by Kumar et al In our study, three out of four patients were immunocompetent. Histoplasmosis commonly found in the immunocompromised patient .…”

Use of destained cytology slides for the application of routine special stains

“…PAS stains a myriad of carbohydrate‐containing substances like glycogen, fibrin, amyloid, certain epithelial sialo‐ and sulphomucins, and fungal cell walls, 1,3 and is useful for demonstrating yeast‐forming fungi 16,18,27 . PAS has been used previously in destained cytologic samples from humans, where it is recommended for the diagnosis of cryptococcosis, when few or thin‐walled organisms are present 28 . To our knowledge, PAS has not been evaluated previously in destained samples from animals, although based on our results, it should also be useful.…”

Cryptococcosis Presenting as Anterior Neck Swelling in an Immunocompetent Man

“…The cytologic picture including smear background and host tissue response vary from gelatinous, granulomatous, cellulitic response to mixed inflammatory responses. 8 The cytologic picture in our case showed an acute inflammatory response superimposed on chronic inflammatory cells. Bright magenta capsules and occasional narrow neck budding were identified.…”

“…Of systemic infections, 10-15% present as cutaneous lesions. 8 Our patient did not have any symptoms or signs relating to either respiratory or neurologic system. The cytologic picture including smear background and host tissue response vary from gelatinous, granulomatous, cellulitic response to mixed inflammatory responses.…”