Related Experiment Videos
Pneumocystis carinii in FNA of the thyroid
1Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA 90048.
Abstract:
We report the diagnosis of Pneumocystis carinii (PC) in a fine-needle aspirate (FNA) from the thyroid of a human immunodeficiency virus infected (HIV+) male receiving aerosolized pentamidine as prophylaxis for Pneumocystis carinii pneumonia (PCP). The clinical diagnosis prior to FNA was multinodular goiter. The patient did not have pulmonary symptoms nor previous diagnosis of PCP at the time of the aspirate diagnosis. Recently, extrapulmonary Pneumocystis carinii (EPC) has been reported with increasing frequency in HIV+ patients receiving prophylactic aerosolized pentamidine. Awareness of extrapulmonary presentations of Pneumocystis carinii infection is a prerequisite for accurate cytologic diagnosis.
Insights
Pneumocystis carinii (PC) was diagnosed in a thyroid fine-needle aspirate (FNA) of an HIV+ patient on pentamidine prophylaxis. This highlights extrapulmonary PC presentations in immunocompromised individuals.
Area of Science:
- Infectious Diseases
- Oncology
- Immunology
Background:
- Pneumocystis carinii pneumonia (PCP) prophylaxis with aerosolized pentamidine is common in human immunodeficiency virus (HIV+) patients.
- Extrapulmonary presentations of Pneumocystis carinii (PC) are increasingly recognized in immunocompromised individuals.
Observation:
- A fine-needle aspirate (FNA) from a thyroid nodule in an HIV+ male patient on aerosolized pentamidine prophylaxis yielded a diagnosis of PC.
- The patient initially presented with multinodular goiter and lacked pulmonary symptoms or a prior PCP diagnosis.
Findings:
- Cytologic diagnosis of extrapulmonary Pneumocystis carinii (EPC) was achieved via FNA of the thyroid.
- The diagnosis was made despite the absence of typical pulmonary symptoms or a history of PCP.
Implications:
- This case underscores the importance of considering extrapulmonary PC in HIV+ patients, even those on prophylactic treatment.
- Increased awareness of atypical PC presentations is crucial for accurate and timely cytologic diagnosis in immunocompromised patients.
- Fine-needle aspiration (FNA) can be a valuable tool for diagnosing extrapulmonary infections in specific clinical contexts.