Tyagi Ruchita, Kaur Arshdeep, Selhi Pavneet Kaur, Puri Harpreet Kaur, Sood Neena
Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
J Lab Physicians. 2016 Jul-Dec;8(2):129-31. doi: 10.4103/0974-2727.180797.
Histoplasma capsulatum is no longer confined to certain geographic areas and should always be considered in the differential diagnosis of lymphadenopathy and organomegaly in HIV-positive patients. We present an unusual case of a 20-year-old immunocompromised male of African origin presenting with fever, jaundice, hepatosplenomegaly, and retroperitoneal and cervical lymphadenopathy. Fine needle aspiration (FNA) smears from the cervical lymph node revealed numerous yeast forms of histoplasma in macrophages. The patient succumbed to the fulminant infection. Postmortem liver biopsy also revealed infiltration by histoplasma, confirming the diagnosis of disseminated histoplasmosis. This case highlights the variable nature of the clinical presentation of disseminated histoplasmosis which can mimic tuberculosis, leishmaniasis, or lymphoma. FNA cytology is a rapid, cost-effective, and reliable diagnostic tool for early detection and prompt management of histoplasmosis.
荚膜组织胞浆菌不再局限于某些地理区域，在对HIV阳性患者的淋巴结病和器官肿大进行鉴别诊断时应始终予以考虑。我们报告一例不寻常病例，一名20岁免疫功能低下的非洲裔男性，出现发热、黄疸、肝脾肿大以及腹膜后和颈部淋巴结病。颈部淋巴结细针穿刺（FNA）涂片显示巨噬细胞内有大量荚膜组织胞浆菌酵母形式。该患者死于暴发性感染。尸检肝活检也显示有荚膜组织胞浆菌浸润，证实为播散性组织胞浆菌病。本病例突出了播散性组织胞浆菌病临床表现的多变性，其可模仿结核病、利什曼病或淋巴瘤。FNA细胞学检查是早期发现和及时处理组织胞浆菌病的一种快速、经济有效且可靠的诊断工具。
