Abati A D, Opitz L, Brones C, Burstein D E, Gallo L
Department of Pathology, New York University Medical Center, New York 10016.
Acta Cytol. 1992 May-Jun;36(3):440-4.
Rare cases of extrapulmonary Pneumocystis carinii (EPPC) have been seen in patients with acquired immunodeficiency syndrome (AIDS). We report seven such diagnoses of nonpulmonary P carinii (PC) from four AIDS patients between 1986 and 1989. The specimens included fine needle aspirate of liver, spleen, periarticular tissue and pleura as well as ankle fluid, pleural fluid and ascites. In some, but not all, cases the patients had concurrent or previous episodes of PC pneumonia. In all cases the typical granular, eosinophilic aggregates of PC cysts were noted on routine Papanicolaou staining, leading to the definitive detection of PC cysts with Grocott silver stain. In most cases, evidence for granulomalike and neovascularized tissue reaction was present in cytologic material. One specimen demonstrated concurrent acid fast bacilli. In the setting of AIDS, cytology of effusions and masses should include an evaluation for EPPC.
在获得性免疫缺陷综合征（AIDS）患者中曾发现过罕见的肺外卡氏肺孢子虫（EPPC）病例。我们报告了1986年至1989年间4例艾滋病患者中7例非肺部卡氏肺孢子虫（PC）的诊断情况。标本包括肝脏、脾脏、关节周围组织和胸膜的细针穿刺抽吸物，以及踝关节液、胸腔积液和腹水。在部分（但并非全部）病例中，患者同时患有或曾患过PC肺炎。在所有病例中，常规巴氏染色均可见典型的PC囊肿颗粒状嗜酸性聚集体，通过Grocott银染色最终检测到PC囊肿。多数病例的细胞学材料中存在类肉芽肿和新生血管组织反应的证据。一份标本显示同时存在抗酸杆菌。在AIDS背景下，对积液和肿块进行细胞学检查时应包括对EPPC的评估。
