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Disseminated histoplasmosis with reactive hemophagocytosis: Aspiration cytology findings in two cases
Author(s) -
Kumar Neeta,
Jain Shyama,
Singh Zeba N.
Publication year - 2000
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/1097-0339(200012)23:6<422::aid-dc13>3.0.co;2-f
Subject(s) - medicine , histoplasmosis , hemophagocytosis , lymph node , hepatosplenomegaly , histiocyte , pathology , tuberculosis , histoplasma , fulminant , cytology , fine needle aspiration , histiocytosis , spleen , bone marrow , pancytopenia , immunology , biopsy , histoplasma capsulatum , disease
Two cases of disseminated histoplasmosis associated with reactive hemophagocytic syndrome are described. The clinical presentation was with prolonged unexplained fever and hepatosplenomegaly. On a strong clinical possibility of tuberculosis, antitubercular treatment was initiated in both patients. Lymph node (case 1), splenic (case 2), and bone marrow aspiration, however, showed sheets of proliferating histiocytes, and intracellular and extracellular histoplasma organisms. Aspiration cytology was thus valuable in establishing the final diagnosis. The patients had a fulminant clinical course and died of hemorrhagic shock within 48 hr of hospital admission before specific therapy could be initiated. Histoplasmosis can mimic tuberculosis clinically. There is a need for an increased awareness of the clinicopathological spectrum of histoplasmosis, especially its rarer manifestations as hemophagocytic syndrome. In suspected cases, aspirations from the lymph node, liver, and spleen can be performed safely and should be utilized for early diagnosis. Diagn. Cytopathol. 2000;23:422–424. © 2000 Wiley‐Liss, Inc.