A Rare Case of a Subcutaneous Phaeomycotic Cyst with a Brief Review of Literature

Phaeohyphomycosis consists of a heterogeneous group of fungal infections caused by more than 80 genera and species. Subcutaneous infection usually follows traumatic implantation of a fungus by a wooden splinter that the fungus inh abits as a saprophyte. The growth of the fungus forms verrucous plaques or a painless subcutaneous abscess. We report a subcutaneous cyst (phaeomycotic cyst) in the leg of a 60-year-old woman that developed after a thorn prick at that site. With the provisional diagnosis of an epidermoid cyst, she was treated with a simple excision of the cyst. However, histopathological examination of the cyst revealed the typical features of fungus, and a definitive diagnosis of a phaeomycotic cyst was made. As the infective aetiology was not considered clinically, the specimen was not sent for microbiological culture, and hence the exact species was not identified. As the lesion was localised, simple excision was sufficient treatment, and no recurrence was observed during 12 months of follow-up.

Rapid diagnosis of Helicobacter pylori infection in gastric imprint smears.

The objective of this study was to determine the sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of Diff-Quik-stained gastric imprint cytology smears in the detection of H. pylori compared with histology. Air-dried imprint smears of gastric biopsies from 150 patients were stained by the Diff-Quik method in the endoscopy suite and examined for H. pylori, providing results within minutes. The presence of inflammation and intestinal metaplasia were documented. The same biopsy was processed and stained with H&E and Warthin-Starry stains, and reviewed by a different pathologist blind to the imprint cytology results. Ninety-four of the 150 patients were male with a mean age of 50 years. Based on histology, the H. pylori prevalence was very low at 8%. The sensitivity and specificity of imprint cytology in the detection of H. pylori were 83.3% and 100%, respectively. The PPV and NPV were 100% and 98.6%, respectively. There were two false negatives and no false positives. A combination of imprint cytology and histology achieved 100% sensitivity. Imprint smears did not provide added value over histology with regards to inflammation and metaplasia. Gastric imprint smears stained with Diff-Quik method is a rapid, cheap, and reliable method for the detection of H. pylori and have their best results when complemented with histology.