'Unstained' and 'de stained' sections in the diagnosis of chromoblastomycosis: A clinico-pathological study.

Background: Diagnosis of chromoblastomycosis is frequently missed for many reasons: (1) rarity of the lesion (2) requirement of careful search for diagnostic 'sclerotic' bodies which are often sparse in clinical material such as tissue and exudates (3) often they elicit tissue reactions such as verrucous lesion and micro abscesses, misleading the diagnosis (4) lack of 'clinical suspicion'. Aims: (1) To compare the feasibility of 'unstained', 'stained' and 'de stained' sections in identification of the diagnostic ' sclerotic' bodies (2) To study histopathological features of chromoblastomycosis, and (3) To highlight the importance of clinical suspicion in the diagnosis of chromoblastomycosis. Design : This is a retrospective study conducted on six clinically unsuspected, histopathologically diagnosed cases of chromoblastomycosis. Results: Most common clinical presentation was verrucous lesion over extremities affecting adult men engaged in outdoor works. Sclerotic bodies and their characteristic features were easily identified in both 'unstained' and 'de stained' sections. Special stains such as Fontana Masson and Gomori's methenamine silver nitrate are useful for demonstrating hyphal forms in keratinized layers and for illustration purposes. Conclusion: Both 'unstained' and 'de stained' sections can be used for rapid screening of sclerotic bodies. 'De stained' sections can be used as a suitable substitute for special stains for confirmation and for retrospective review of all verrucous lesions to diagnose the missed lesion. Clinical suspicion is very important in the diagnosis of chromoblastomycosis as it helps pathologist to screen for diagnostic sclerotic bodies.

Cerebral aspergilloma presenting as atypical meningioma in an immunologically competent patient: a case report.

A 36-year-old man presented with history suggestive of intracranial space occupying lesion. Computed tomography of brain revealed a large lobulated, extra axial, hyperdense lesion in the right fronto-temporal region extending up to to the right frontal and ethmoidal sinuses, eroding the bone, enhancing homogeneously with contrast, which was suggestive of atypical meningioma. He had no predisposing factors that could lead to the suspicion of opportunistic infection. Craniotomy and total excision of the lesion was done. Histopathological study revealed aspergilloma.