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Pulmonary mycetomas in immunocompetent patients: Diagnosis by fine‐needle aspiration
Author(s) -
Stanley Michael W.,
Deike Marcia,
Knoedler John,
Iber Conrad
Publication year - 1992
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/dc.2840080607
Subject(s) - medicine , malignancy , fine needle aspiration , lung abscess , lung , tuberculosis , abscess , surgery , pulmonary hemorrhage , radiology , pathology , biopsy
Mycetomas usually grow within preexisting cavities and frequently lead to pulmonary hemorrhage. We describe four males, aged 38 to 72 years, in whom mycetomas were diagnosed by FNA. Preexisting cavitary lesions resulted from tuberculosis, anaerobic absess, and bullous lung disease (two cases). Fine needle aspiration yielded tangled mats of fungal hyphae (large and grossly visible in three cases) and acute inflammatory cells. The atypical cells often seen in the walls of such lesions were not identified. Cultures showed Aspergillus (3 cases) Pseudoallescheria boydii (1 case). The diagnosis was surgically confirmed in two cases. Two patients were too ill for surgery and the fourth refused. At 7 and 10 months, the two remaining individuals have pulmonary hemorrhage but no evidence of progression or malignancy. In poor surgical candidates, conservative management of mycetomas diagnosed by fine needle aspiration is appropriate. Excluding mycetoma secondary to cavitary lung carcinoma requires careful correlation of historical, clinical, radiographic, cytologic, and follow‐up data. © 1992 Wiley‐Liss, Inc.