title: Subcutaneous Fungal Cyst Masquerading as Benign Lesions - A Series of Eight Cases.
abstract: BACKGROUND
  Subcutaneous fungal infections are caused by penetration of the causative fungi into the subcutaneous layer and are usually localised. We present a series of eight cases with subcutaneous fungal cystic lesions masquerading as benign lesions.
  
  
  METHODS
  A retrospective study was conducted on subcutaneous fungal infections seen between January 2007 to July 2014 in the Department of Pathology. Eight patients with biopsy proven subcutaneous fungal infection were included. We collected and analysed their demographic, clinical and histopathological details.
  
  
  RESULTS
  Among eight patients, six were male and two were female. The mean age was 47 years (Range: 21-70). All the eight patients presented with non-tender cystic swelling. The size of the swellings varied from a minimum of 3x3 cm to maximum of 10x4 cm. Out of eight, hand was involved in three, forearm in one, elbow in two, leg in one and foot in one. On H&E staining, all the cases showed fibro collagenous cyst wall, lined by histiocytes, granulomatous reaction, foreign body type of giant cells with acute and chronic inflammatory infiltrate containing fungal elements. Six were identified as hyalohyphomycosis and two were identified as phaeohyphomycotic cysts based on pigmentation of hyphae.
  
  
  CONCLUSIONS
  Fungal infection should be suspected in all subcutaneous cystic lesions. Excised tissue should always be sent for culture and histopathology.
authors.affiliation: Postgraduate Student, Department of Pathology, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Gayathri
authors.initials: G
authors.lastname: Priyadharshini
authors.affiliation: Professor, Department of Pathology, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Renu G'Boy
authors.initials: RG
authors.lastname: Varghese
authors.affiliation: Professor, Department of Pathology, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Manjiri
authors.initials: M
authors.lastname: Phansalkar
authors.affiliation: Professor, Department of Pathology, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Anita
authors.initials: A
authors.lastname: Ramdas
authors.affiliation: Professor, Department of Surgery, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Authy
authors.initials: A
authors.lastname: K
authors.affiliation: Professor, Department of Surgery, Pondicherry Institute of Medical Sciences , Pondicherry, India .
authors.forename: Thangiah
authors.initials: T
authors.lastname: G
keywords: Cysts; Fungi; Hyalohyphomycoses; Mycoses; Subcutaneous pheohyphomycoses