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Storage Artifact Masquerading as Yeast: Presenting a Diagnostic Pitfall
Elena M Fenu1, Tawfeq Naal1, Elizabeth Palavecino1
1Department of Pathology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
Abstract:
Abnormal cell morphology can result from prolonged specimen storage, both for red and white blood cells. In particular, nuclear pyknosis of segmented neutrophils can occur in both peripheral blood and body fluids and may represent a diagnostic pitfall as it can mimic intracellular yeast or bacteria morphology. Pathologists are frequently asked to examine body fluid smears which are thought to contain microorganisms, and the presence of an unexpected organism can be especially concerning. Morphologic changes from prolonged storage may be encountered infrequently, and it is important to be aware of them in order to avoid misrepresentation, as additional work-up may be required for a suspected case of an unexpected fungal infection.
Insights
Prolonged storage of blood and body fluid samples can alter cell appearance. This nuclear pyknosis in neutrophils may mimic infections, leading to potential misdiagnosis.
Area of Science:
- Hematology
- Cytopathology
Background:
- Cellular morphology is crucial for diagnosing infections and other conditions.
- Specimen integrity is vital for accurate microscopic examination.
Observation:
- Prolonged storage of blood and body fluid specimens can induce abnormal cell morphology.
- Nuclear pyknosis in segmented neutrophils is a notable change, affecting both peripheral blood and body fluid samples.
Findings:
- Nuclear pyknosis can be mistaken for intracellular microorganisms like yeast or bacteria.
- This morphologic alteration poses a diagnostic challenge, particularly in body fluid analysis.
Implications:
- Awareness of storage-induced changes is essential to prevent misdiagnosis of infections.
- Misidentification may lead to unnecessary investigations for fungal or bacterial infections.
- Accurate interpretation requires differentiating artifact from true pathological findings.
