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Asymptomatic pulmonary cryptococcosis diagnosed on fine needle aspiration cytology. A case report
A S Bhaduri1, G P Amonkar, P P Amonkar
1Department of Surgical Pathology, P. D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, Mumbai 400016, India.
Background:
Cryptococcosis can be a life-threatening mycosis in immunocompromised patients. However, it has a somewhat better prognosis in immunocompetent hosts. AIDS has led to an increase in the incidence of the disease. Clinically, the lesions can be confused easily with malignancy.
Case:
A 25-year-old, asymptomatic male presented for a routine health check-up. The chest radiograph showed a subpleural left apical area of consolidation, suspicious for either a neoplasm or infection. Fine needle aspiration cytology (FNAC) revealed a granulomatous lesion with refractile yeast forms of Cryptococcus, both within the multinucleate giant cells and extracellularly. This was subsequently confirmed by culture and histology.
Conclusion:
The cytomorphology of cryptococcosis is characteristic, and FNAC is a useful modality for diagnosing the infection in asymptomatic patients but needs a high index of suspicion, especially in nonimmunocompromised patients.