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表现为软组织肿胀的皮肤及皮下真菌病的细胞病理学研究:来自印度南部一家三级护理中心的5年回顾性研究。

Cytopathological study of cutaneous and subcutaneous mycosis presenting as soft-tissue swellings: A 5-year retrospective study from a tertiary care center in South India.

作者信息

Konkay Kaumudi, Golajapu Rajeswari, Chaganti Padmavathi Devi, Janani B, Haque Mohammed Zafrul

机构信息

Department of Pathology, Guntur Medical College, Guntur, Andhra Pradesh, India.

出版信息

Cytojournal. 2022 Oct 1;19:54. doi: 10.25259/Cytojournal_30_2021. eCollection 2022.

Abstract

OBJECTIVES

Cutaneous and subcutaneous mycosis can mimic skin and soft-tissue neoplasms clinically and pose diagnostic challenge to pathologists on cytology. Since there are a limited number of studies on this topic from South India and etiological agents vary with geographic region, in this paper, we present clinical and cytological features of the same the objective of this study is to review and evaluate clinical and cytological features of subcutaneous and cutaneous mycosis with histopathological correlation wherever available.

MATERIALS AND METHODS

This was an observational and retrospective study of 5-year duration. All cases diagnosed as mycosis on cytology were retrieved from pathology records. Cytology slides along with special stains for fungus were reviewed. Review of histopathology slides and culture correlation was done whenever available. Statistical analysis was done using frequencies and percentages.

RESULTS

There were 39 cases during the study period (male - 34 and female - 5). On aspiration, all cases yielded pus; microscopy revealed necrotic debris in 39 cases, inflammatory infiltrate in 39 cases, epithelioid granulomas with multinucleated giant cells in 25 cases, and negative staining hyphal forms in 37 cases. Special stains for fungus showed septate hyphal forms suggestive of species in 34 cases, and yeast and pseudo hyphal forms of candida species in one case. A broad category as fungal infection without subtyping was given in four cases. Culture did not yield growth but fungus was identified on KOH mounts. Histopathology showed fungus in 13 of 14 cases done.

CONCLUSION

Subcutaneous mycosis should be suspected when aspiration yields pus and appropriate special stains must be done. species was the most common etiological agent in our study.

摘要

目的

皮肤及皮下真菌病在临床上可酷似皮肤和软组织肿瘤,给病理学家的细胞学诊断带来挑战。由于来自印度南部关于该主题的研究数量有限,且病原体因地理区域而异,在本文中,我们呈现了其临床和细胞学特征。本研究的目的是回顾和评估皮下及皮肤真菌病的临床和细胞学特征,并在可行时与组织病理学进行关联。

材料与方法

这是一项为期5年的观察性回顾性研究。从病理记录中检索出所有经细胞学诊断为真菌病的病例。复查了细胞学玻片以及真菌特殊染色。如有可能,对组织病理学玻片进行复查并与培养结果进行关联。使用频率和百分比进行统计分析。

结果

研究期间共有39例病例(男性34例,女性5例)。抽吸时,所有病例均抽出脓液;显微镜检查显示39例有坏死碎屑,39例有炎性浸润,25例有上皮样肉芽肿及多核巨细胞,37例有阴性染色的菌丝形态。真菌特殊染色显示34例有提示某种菌种的分隔菌丝形态,1例有念珠菌属的酵母和假菌丝形态。4例归为未分型的真菌感染大类。培养未生长,但在氢氧化钾涂片上鉴定出真菌。14例进行组织病理学检查的病例中有13例显示有真菌。

结论

当抽吸抽出脓液时应怀疑皮下真菌病,必须进行适当的特殊染色。在我们的研究中,某种菌种是最常见的病原体。

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