Fine-needle aspiration biopsy in fungal infections

To evaluate the role of fine-needle aspiration biopsy (FNAB) in diagnosis of fungal infections, a retrospective analysis of 26 cases of fungal infection is described. The spectrum of various fungi encountered on cytologic microscopy of aspirated material and fungal culture was as follows: Aspergillus sp (16 cases), Cryptococcus neoformans (six cases), Mucorales (one case), Candida sp (one case), Phialophora parasiticus (one case), Sporothrix schenkii and Cladosporium sp (the last two isolated from a single case). In majority (71%) of cases, fungal infection was not clinically suspected but was picked up on cytologic material in all the cases. An accurate diagnosis based on morphology could be made in 21 cases (80%). Predisposing factor was found in three patients, two of them had diabetes mellitus and one was on immunosuppression. HIV serology was negative in seven cases tested. Commonest tissue reaction (75%) was foreign body giant cells with foamy macrophages and variable amount of necrosis. Although FNAB is helpful in the rapid diagnosis of fungal infections, culture is essential for more accurate identification.