Squamous Cell Proliferation as a Reactive Mechanism to Laryngeal Cryptococcus Infection: A Case Report

Abstract

Cryptococcus neoformans ( C. neoformans) is a ubiquitous encapsulated, obligate anaerobe, a dimorphic fungus that can be pathogenic in humans. C. neoformans infections arise primarily in immunocompromised individuals, such as human immunodeficiency virus (HIV) patients, as well as those who use inhaled corticosteroids regularly. Due to the wide variety of clinical findings associated with C. neoformans, infection within the head and neck is occasionally misdiagnosed as malignancy due to its protean manifestation. In this report, we describe the case of a C. neoformans infection resulting in an initial misdiagnosis due to an overlying laryngeal squamous cell proliferation mimicking laryngeal squamous cell carcinoma (SCC). This case is intended to provide further evidence for inhaled corticosteroid use predisposing patients to fungal infections, as well as to provide insight into the possible mechanism resulting in the initial diagnosis of malignancy. A review of recent literature is also discussed.

Pathologic findings of acantholytic squamous cell carcinoma coexisting with cutaneous cryptococcosis in a Houbara bustard (Chlamydotis undulata)

“…Histopathologic results showed atypical squamous proliferation, acute inflammation, and scattered round-shaped microorganisms surrounded by clear halos. It was diagnosed as laryngeal squamous cell carcinoma (SCC), due to an overlying laryngeal squamous cell proliferation (14). Squamous pseudoepitheliomatous hyperplasia (PEH) is a reactive epithelial proliferation that may occur secondary to different factors including infection, injury and inflammation.…”