Exfoliative cytology: a helpful tool for the diagnosis of paracoccidioidomycosis.
OBJECTIVE
To describe the main cytological findings associated with smears collected from oral lesions of paracoccidioidomycosis and to appraise the use of cytology as a diagnostic tool for the disease.


METHODS
Cytological smears and biopsies were collected from 40 lesions with a clinical suspicion of paracoccidioidomycosis. Evaluation of the sensitivity, specificity, positive and negative predictive values, accuracy and the positive likeness ratio of the oral smear when compared with the histological diagnosis, was performed. The latter is considered the 'gold standard' for comparison.


RESULTS
The main morphological findings were the rounded-shaped, birefringent and multiple-budded fungi, Langhans' giant cells and epithelioid cells. The following associative measures were found: sensitivity, 67.9%; specificity, 91.7%; positive predictive value, 95.0%; negative predictive value, 55.0%; accuracy, 75.0%; and positive likeness ratio, 8.14.


CONCLUSIONS
The cytological findings of paracoccidioidomycosis are characteristic and cytology is accurate in the diagnosis of the disease. Positive patients should be treated. Negative patients should be submitted to biopsy to confirm or to dismiss the diagnosis of this mycosis.
Cardoso
S V
SV
Department of Oral Pathology, School of Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil.
Moreti
M M
MM
Costa
I M
IM
Loyola
A M
AM
D001706:Biopsy; D004396:Coloring Agents; D003581:Cytodiagnosis / Q000379:methods*; D015744:Giant Cells, Langhans / Q000473:pathology; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D009059:Mouth Diseases / Q000382:microbiology*; D010228:Paracoccidioides / Q000145:classification; D010229:Paracoccidioidomycosis / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D011336:Probability; D012680:Sensitivity and Specificity; D013223:Statistics as Topic
D004396:Coloring Agents