Cryptococcal osteomyelitis. Report of a case with aspiration biopsy of a humeral lesion with radiologic features of malignancy.
BACKGROUND
Osteomyelitis due to Cryptococcus neoformans typically exhibits lytic lesions on radiographs. Extensive periosteal reaction is an uncommon feature.


METHODS
A 68-year-old man presented with pain and swelling in the left elbow. Radiologic studies exhibited a lytic humeral lesion with extensive periosteal reaction, interpreted as a malignant neoplasm. Fine needle aspiration biopsy (FNA) revealed abundant cryptococcal organisms.


CONCLUSIONS
Cryptococcus is an uncommon cause of lytic osseous lesions that may mimic malignant neoplasms. Extensive periosteal reaction may support a radiologic diagnosis of primary osseous malignancy in rare cases. FNA with examination of Diff-Quik-stained slides may be employed for distinguishing cryptococcal osteomyelitis from malignant tumors and for prompt identification of the organisms.
Witte
D A
DA
Department of Pathology, Baylor College of Medicine, Houston, Texas, USA.
Chen
I
I
Brady
J
J
Ramzy
I
I
Truong
L D
LD
Ostrowski
M L
ML
D000368:Aged; D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D003453:Cryptococcosis / Q000175:diagnosis / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D011859:Radiography