Lymphonodular cryptococcosis diagnosed by fine needle aspiration cytology in hyper-IgM syndrome. A case report.

Abstract

BACKGROUND:

Most cases of cryptococcosis are diagnosed when signs of meningitis have appeared. We report a case of lymphonodular cryptococcosis that was diagnosed by fine needle aspiration cytology (FNAC), excisional biopsy of a cervical lymph node and culture of aspirated material.

CASE:

An 11-year-old boy presented with a history of fever and enlarged bilateral cervical lymph nodes of two weeks' duration. Past medical history included immunoglobulin replacement for hyper-IgM syndrome for the previous eight years. FNAC smears from a cervical lymph node showed numerous yeasts of various sizes, ranging from 5 to 15 microns in diameter, located in the cytoplasm of multinucleated giant cells and in the background. In air-dried, Diff-Quik-stained slides, the yeasts stained blue and were surrounded by clear halos. Aspirated material collected in the syringe was cultured, and Cryptococcus neoformans was isolated.

CONCLUSION:

This case report suggests that a combination of FNAC and culture is a simple and useful method of diagnosing fungal infections. Early diagnosis by FNAC makes possible the early initiation of treatment.

• Authors: M Y Lee, J H Chung, J H Shin, T J Hwang, K S Kim, J H Lee, J H Nam, M C Lee, C S Park, S W Juhng, C Choi
• Journal: Acta cytologica (Acta Cytol) 2001 Mar-Apr Vol. 45 Issue 2 Pg. 241-4 ISSN: 0001-5547 [Print] Switzerland
• PMID: 11284311 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Immunoglobulin M

Topics

• Biopsy, Needle
• Child
• Cryptococcosis (complications, diagnostic imaging, microbiology, pathology)
• Cryptococcus neoformans (cytology, isolation & purification)
• Humans
• Hypergammaglobulinemia (complications)
• Immunoglobulin M (blood)
• Lymph Nodes (diagnostic imaging, microbiology, pathology)
• Male
• Neck
• Opportunistic Infections (complications, diagnostic imaging, pathology)
• Syndrome
• Tomography, X-Ray Computed