ABSTRACT
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.
ABSTRACT
Primary non-Hodgkin's lymphoma of the skull with extra- and intracranial extension without systemic or skeletal manifestation in a nonimmunocompromised patient is extremely rare. These lesions often cause difficulty in diagnosis because they mimic other conditions. We report a case of primary lymphoma involving scalp, skull vault, meninges and invading the brain parenchyma and masquerading clinically and radiologically as a meningioma.
Subject(s)
Adult , Female , Head and Neck Neoplasms/pathology , Humans , Lymphoma, Non-Hodgkin/complications , Meningeal Neoplasms/pathology , Meningioma/pathology , Scalp/pathology , Skin Neoplasms/pathology , Skull Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
Accessory nerve schwannoma are extremely rare. The preoperative consideration of this diagnosis will lead to appropriate surgical management with preservation of motor nerve function. In this article we review the literature and report a case treated successfully based on preoperative MRI findings.
Subject(s)
Adult , Female , Humans , Magnetic Resonance Imaging , Neurilemmoma/diagnosis , Peripheral Nervous System Neoplasms/diagnosis , Spinal NervesABSTRACT
A case of recurrent sino-naso-orbital fungal infection due to Pseudallescheria boydii described in a 28 yrs. old man, who appeared immunocompetent, and was found negative for HIV I and II by ELISA tested on two occasions. The fungal culture was negative. It is very essential to identify P boydii as Miconazole is the only antifungal drug of choice for this fungus. The pathologist plays an important role in identifying this fungus when fungal culture fails to yield the growth. The pathologist has to look for clinching clues such as "intercalary conidia" and "chlamydoconidia" to distinguish P boydii from Aspergillus.
Subject(s)
Adult , Antifungal Agents/therapeutic use , Chronic Disease , Humans , Immunocompetence , Male , Miconazole/therapeutic use , Mycoses/diagnosis , Orbital Diseases/diagnosis , Pseudallescheria/drug effects , Sinusitis/diagnosisABSTRACT
Rhinosporidiosis was the commonest (68%) fungal lesion encountered during the period of 11 1/2 years from January 1987 to July 1998. Men in 2nd, 3rd, 4th decade were commonly affected. Nose and nasopharynx were the commonest (85%) sites involved followed by ocular tissue (9%). One patient had involvement of bone (tibia). Generally a lymphoplasmacytic response was observed in all cases. Polymorphonuclear leukocytic response mostly observed at the site of rupture of sporangia. Epithelioid cell granulomatous and giant cell response observed in 47% of cases. Transepithelial migration of sporangia observed in 76% of cases. Rhinosporidium seeberi could be easily identified in haematoxylin and eosin stained sections. The walls of young trophic forms are delineated well with the PAS stain and verhoeff van Gieson stain.