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Gastrointestinal basidiobolomycosis. Morphologic findings in a cluster of six cases
O M Yousef1, J D Smilack, D M Kerr
1Department of Pathology and Laboratory Medicine, Mayo Clinic Scottsdale, AZ, USA.
Abstract:
We describe the histopathologic features of 6 cases of gastrointestinal basidiobolomycosis examined at 4 Phoenix, AZ, area hospitals during the last 4 years. Resected stomach and intestinal specimens were characterized by marked mural thickening with fibrosis, prominent tissue eosinophil infiltration and palisading granulomatous inflammation around pale fungal hyphae. In 2 cases, there was colonic perforation. Basidiobolus ranarum hyphae (associated with spore-like spherules in 4 cases) were identified within tissue sections; the irregularly branched, thin-walled, occasionally septated hyphae were typically surrounded by a thick eosinophilic cuff (Splendore-Hoeppli phenomenon). Although the histologic features of B ranarum are well described in the skin and subcutaneous tissue, gastrointestinal involvement has presented considerable diagnostic difficulty. Before the occurrence of this cluster of cases, intra-abdominal B ranarum infection has been reported only rarely.
Insights
Gastrointestinal basidiobolomycosis, a rare fungal infection, presents unique histopathologic features. This study details 6 cases, highlighting diagnostic challenges in identifying Basidiobolus ranarum in abdominal tissues.
Area of Science:
- Gastroenterology
- Mycology
- Pathology
Background:
- Gastrointestinal basidiobolomycosis is a rare fungal infection.
- Basidiobolus ranarum is typically associated with cutaneous and subcutaneous infections.
- Intra-abdominal cases of B. ranarum are infrequently reported, posing diagnostic challenges.