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Ahuja S, Singh M. Cryptococcal lymphadenitis-First presentation in an HIV-positive patient. Cytopathology 2023; 34:279-280. [PMID: 36588158 DOI: 10.1111/cyt.13206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023]
Abstract
Cryptococcal infection is a life-threatening, opportunistic infection in human immunodeficiency virus-infected individuals. The infection most commonly begins in the respiratory tract, with secondary involvement of the brain, skin, and lymph nodes. We report a rare case of isolated cervical cryptococcal lymphadenitis diagnosed on fine needle aspiration cytology, which was the initial presentation of secondary immunodeficiency in the patient. Periodic acid-Schiff stain, India ink preparation, and culture were done to confirm the diagnosis. He was diagnosed as HIV-positive on further investigation.
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Affiliation(s)
- Sana Ahuja
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Mukul Singh
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Cazorla A, Alanio A, Bretagne S, Polivka M, Shaar-Chneker C, Kaci R, Brouland JP, Chrétien F, Jouvion G. [Cryptococcus where they are not expected: Five case reports of extra-cerebral and extra-pulmonary cryptococcosis]. Ann Pathol 2015; 35:479-85. [PMID: 26596691 DOI: 10.1016/j.annpat.2015.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 10/01/2015] [Indexed: 12/29/2022]
Abstract
Cryptococcosis is a serious infection, possibly lethal, of worldwide distribution. It mainly affects immunosuppressed patients resulting with pulmonary and/or meningeal involvements or disseminated infections. Due to the rarity of visceral and osseous infections, and to the absence of specific clinical symptoms, this diagnosis is often deferred. Resulting of diagnostic errors, samples are often directed to the department of pathology and more rarely to the department of mycology. Histopathological examination appears crucial, highlighting encapsulated yeasts with alcian blue staining. Once the diagnosis is performed, an appropriate antifungal therapy must be quickly introduced because these infections are associated with a high mortality rate. The aim of our work was to report five extra-cerebral and extra-pulmonary cryptococcosis cases, to describe their histopathological features, to evoke diagnostic techniques and to discuss the differential diagnoses.
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Affiliation(s)
- Arnault Cazorla
- Service de pathologie, AP-HP Lariboisière, 2, avenue Ambroise-Paré, 75475 Paris, France; Service d'anatomie et cytologie pathologiques, AP-HP Lariboisière, 2, avenue Ambroise-Paré, 75475 Paris, France.
| | - Alexandre Alanio
- Service de parasitologie-mycologie, AP-HP, hôpital Saint-Louis, 75010 Paris, France; Unité de mycologie moléculaire, CNRS URA3012, Institut Pasteur, Centre national de référence mycoses invasives et antifongiques, 28, rue du Dr.-Roux, 75724 Paris, France
| | - Stéphane Bretagne
- Service de parasitologie-mycologie, AP-HP, hôpital Saint-Louis, 75010 Paris, France; Unité de mycologie moléculaire, CNRS URA3012, Institut Pasteur, Centre national de référence mycoses invasives et antifongiques, 28, rue du Dr.-Roux, 75724 Paris, France
| | - Marc Polivka
- Service de pathologie, AP-HP Lariboisière, 2, avenue Ambroise-Paré, 75475 Paris, France
| | | | - Rachid Kaci
- Service de pathologie, AP-HP Lariboisière, 2, avenue Ambroise-Paré, 75475 Paris, France
| | | | - Fabrice Chrétien
- Unité d'histopathologie humaine et modèles animaux, Institut Pasteur, 28, rue du Dr.-Roux, 75724 Paris, France; Service de neuropathologie, centre hospitalier Sainte-Anne, 1, rue Cabanis, 75475 Paris, France; Université Paris Descartes, PRES Sorbonne Paris Cité, 75006 Paris, France
| | - Grégory Jouvion
- Unité d'histopathologie humaine et modèles animaux, Institut Pasteur, 28, rue du Dr.-Roux, 75724 Paris, France; Université Paris Descartes, PRES Sorbonne Paris Cité, 75006 Paris, France
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Lazzara M, Joshi A. Disseminated cryptococcosis involving the head and neck. BMJ Case Rep 2014; 2014:bcr-2013-202306. [PMID: 24495975 DOI: 10.1136/bcr-2013-202306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A middle-aged patient with HIV presented with very distinctive maculopapular cutaneous lesions involving the face and lymphadenopathy confined to the neck. A diagnosis of disseminated cryptococcosis was made based on pathological analysis of lymph node and skin lesions.
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Lang TU, Khalbuss WE, Monaco SE, Michelow P, Pantanowitz L. Review of HIV-Related Cytopathology. PATHOLOGY RESEARCH INTERNATIONAL 2011; 2011:256083. [PMID: 21559199 PMCID: PMC3090088 DOI: 10.4061/2011/256083] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 02/15/2011] [Indexed: 11/28/2022]
Abstract
Exfoliative and aspiration cytologies play a major role in the management of patients with human immunodeficiency virus infection. Common cytology samples include cervicovaginal and anal Papanicolaou tests, fine needle aspirations, respiratory specimens, body fluids, Tzanck preparations, and touch preparations from brain specimens. While the cytopathologists need to be aware of specific infections and neoplasms likely to be encountered in this setting, they should be aware of the current shift in the pattern of human immunodeficiency virus-related diseases, as human immunodeficiency virus patients are living longer with highly active antiretroviral therapy and suffering fewer opportunistic infections with better antimicrobial prophylaxis. There is a rise in nonhuman immunodeficiency virus-defining cancers (e.g., anal cancer, Hodgkin's lymphoma) and entities (e.g., gynecomastia) from drug-related side effects. Given that fine needle aspiration is a valuable, noninvasive, and cost-effective tool, it is frequently employed in the evaluation and diagnosis of human immunodeficiency virus-related diseases. Anal Papanicolaou tests are also increasing as a result of enhanced screening of human immunodeficiency virus-positive patients for cancer. This paper covers the broad spectrum of disease entities likely to be encountered with human immunodeficiency virus-related cytopathology.
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Affiliation(s)
- Tee U. Lang
- Department of Pathology, University of Pittsburgh Medical Center Cancer Pavilion, 5150 Centre Avenue, Suite 201, Pittsburgh, PA 15232, USA
| | - Walid E. Khalbuss
- Department of Pathology, University of Pittsburgh Medical Center Cancer Pavilion, 5150 Centre Avenue, Suite 201, Pittsburgh, PA 15232, USA
| | - Sara E. Monaco
- Department of Pathology, University of Pittsburgh Medical Center Cancer Pavilion, 5150 Centre Avenue, Suite 201, Pittsburgh, PA 15232, USA
| | - Pam Michelow
- Cytology Unit, Department of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, Johannesburg 2192, South Africa
| | - Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center Cancer Pavilion, 5150 Centre Avenue, Suite 201, Pittsburgh, PA 15232, USA
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