[A pathological study on cerebral mycosis].

The histopathological examination was performed in search of cerebral mycosis in autopsy cases at our department during the 6 years from 1976 to 1981. The cerebral mycoses were histopathologically verified in seven cases, although brain tissue was examined in only 46% of 528 autopsy cases. All cases of cerebral mycosis showed underlying diseases which were hematologic diseases (5 cases), SLE (1 case), and myocardial infarction with indwelling deep venous lines (1 case). Among these cerebral mycosis, one had double fungal infections with aspergillus and candida, while others were as follows; aspergillosis (2 cases), mucormycosis (2 cases), candidiasis (1 case) and cryptococcosis (1 case). Six cases were not diagnosed antemortem with exception of a case of cryptococcosis. Systemic fungal infections were seen in six cases, however, a case of mucormycosis was without systemic infection. Each cerebral mycosis showed its own characteristic histopathologic findings, namely, hemorrhagic and necrotic lesions in aspergillosis and mucormycosis, scattered minute abscesses or granulomatous lesions in candidiasis, and gelatinous lesions in leptomeninges in cryptococcosis. Severe lymphocytopenia (less than 500/mm3) was always present in all except a case of rhinocerebral mucormycosis. It is emphasized that cerebral mycosis should be always considered when neurological symptoms were clinically observed in patients who had severe underlying diseases and/or deep venous lines with severe lymphocytopenia.