Lymphonodular cryptococcosis diagnosed by fine needle aspiration cytology in hyper-IgM syndrome. A case report.
BACKGROUND
Most cases of cryptococcosis are diagnosed when signs of meningitis have appeared. We report a case of lymphonodular cryptococcosis that was diagnosed by fine needle aspiration cytology (FNAC), excisional biopsy of a cervical lymph node and culture of aspirated material.


METHODS
An 11-year-old boy presented with a history of fever and enlarged bilateral cervical lymph nodes of two weeks' duration. Past medical history included immunoglobulin replacement for hyper-IgM syndrome for the previous eight years. FNAC smears from a cervical lymph node showed numerous yeasts of various sizes, ranging from 5 to 15 microns in diameter, located in the cytoplasm of multinucleated giant cells and in the background. In air-dried, Diff-Quik-stained slides, the yeasts stained blue and were surrounded by clear halos. Aspirated material collected in the syringe was cultured, and Cryptococcus neoformans was isolated.


CONCLUSIONS
This case report suggests that a combination of FNAC and culture is a simple and useful method of diagnosing fungal infections. Early diagnosis by FNAC makes possible the early initiation of treatment.
Department of Pathology, Clinical Pathology and Pediatrics, Chonnam National University Medical School, Chonnam University Research Institute of Medical Science, Kwangju, Korea.
M Y
MY
Lee
J H
JH
Chung
J H
JH
Shin
T J
TJ
Hwang
K S
KS
Kim
J H
JH
Lee
J H
JH
Nam
M C
MC
Lee
C S
CS
Park
S W
SW
Juhng
C
C
Choi
D001707:Biopsy, Needle; D002648:Child; D003453:Cryptococcosis / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology*; D003455:Cryptococcus neoformans / Q000166:cytology / Q000302:isolation & purification; D006801:Humans; D006942:Hypergammaglobulinemia / Q000150:complications*; D007075:Immunoglobulin M / Q000097:blood; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D008297:Male; D009333:Neck; D009894:Opportunistic Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D013577:Syndrome; D014057:Tomography, X-Ray Computed
D007075:Immunoglobulin M