Exfoliative cytology in the rapid diagnosis of pulmonary blastomycosis

Four patients with pulmonary blastomycosis are reported. Their bronchial washings, submitted for cytologic evaluation and stained by the standard Papanicolau technique, yielded the diagnosis, subsequently confirmed by cultural identification of the fungus. In three additional cases, retrospective evaluation of cytologic material also revealed the organism, even though the diagnostic significance was not appreciated originally. Since cytologic techniques are simple, readily available, and rapid, they can be helpful in differentiating pulmonary neoplasms from pulmonary blastomycosis, thus reducing the need for diagnostic thoracotomies.