title: Polymicrobial lung infection in postrenal transplant recipient diagnosed by fine-needle aspiration cytology.
abstract: Tuberculous and fungal infections are among the non-neoplastic lesions of the lung, in which fine-needle aspiration cytology (FNAC) has proven to be a useful technique in both immunocompromised and immunocompetent patients. The presence of polymicrobial infection in a renal transplant recipient is documented in the literature, but has rarely been diagnosed on cytology. We report a case of concomitant pulmonary cryptococcosis, aspergillosis, and tuberculosis in a renal transplant recipient diagnosed on FNAC.A 50-year-old renal transplant recipient, asymptomatic for 3 year, presented with intermittent low-grade fever associated with cough, expectoration, and a newly developed cavitatory lesion in the left lung on chest X-ray. Computed tomography-guided FNAC performed on the lung lesion showed fungal profiles with septate hyphae and acute-angled branching consistent with morphology of Aspergillus. In addition, numerous yeast forms of cryptococcus and a few acid-fast mycobacterial tubercle bacilli were seen.Guided FNAC is a useful and reliable technique for the diagnosis of pulmonary infection. One should always keep in mind the possibility of polymicrobial infections especially inimmunocompromised patients.
authors.affiliation: Department of Cytopathology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Rajan
authors.initials: R
authors.lastname: Duggal
authors.forename: Arvind
authors.initials: A
authors.lastname: Rajwanshi
authors.forename: Nalini
authors.initials: N
authors.lastname: Gupta
authors.forename: Anupam
authors.initials: A
authors.lastname: Lal
authors.forename: Manphool
authors.initials: M
authors.lastname: Singhal
mesh_terms: D001230:Aspergillus / Q000166:cytology; D044963:Biopsy, Fine-Needle; D003454:Cryptococcus / Q000166:cytology; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008168:Lung / Q000382:microbiology* / Q000473:pathology*; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000382:microbiology* / Q000473:pathology*; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000166:cytology; D011859:Radiography