Eyelid and conjunctival paracoccidioidomycosis simulating carcinoma.
Paracoccidioidomycosis (PCM) is the most prevalent systemic mycosis in immunocompetent individuals in Brazil. Ocular infection by PCM is rare; however, when infection does occur, the most common ocular sites involved are eyelid and conjunctiva. A 68-year-old white male presented with a 2-month history of a painless, ulcerated, infiltrative and diffuse whitish lesion located on the right inferior eyelid. A clinical diagnosis of malignant tumor, possibly squamous cell carcinoma, was made. The histopathologic examination showed a hyperplastic epithelium with inflammatory infiltrate of lymphocytes, plasma cells, neutrophils and histiocytes. Large numbers of giant cells were also present. Periodic acid Schiff and Grocott (silver methenamine) stains showed several large round structures with peripheral lateral small budding cells that resembled a "ship's wheel". No multinucleated fungi were seen. The fungi varied in size and small forms were round and single fungal structures. A diagnosis of paracoccidioidomycosis was made PCM eyelid infection is rare and can simulate carcinoma both clinically and histopathologically.
Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil. alexandrenakao@yahoo.com.br
Alexandre N
AN
Odashiro
Patricia R P
PR
Odashiro
Priscila I
PI
Fernandes
Lívio V O
LV
Leite
Maçanori
M
Odashiro
Shawn
S
Maloney
Bruno F
BF
Fernandes
Sebastian
S
Di Cesare
Miguel N
MN
Burnier
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D003229:Conjunctival Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D015821:Eye Infections, Fungal / Q000175:diagnosis*; D005134:Eye Neoplasms; D005141:Eyelid Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D010228:Paracoccidioides; D010229:Paracoccidioidomycosis / Q000175:diagnosis*