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Differential diagnosis of trichosporonosis using conventional histopathological stains and electron microscopy
Author(s) -
Obana Yukari,
Sano Makoto,
Jike Toyoharu,
Homma Taku,
Nemoto Norimichi
Publication year - 2010
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2010.03477.x
Subject(s) - pathology , differential diagnosis , electron microscope , microscopy , medicine , optics , physics
Obana Y, Sano M, Jike T, Homma T & Nemoto N
(2010) Histopathology 56, 372–383 Differential diagnosis of trichosporonosis using conventional histopathological stains and electron microscopyAims: Although Trichosporon is a causative pathogen of white piedra and summer‐type hypersensitivity pneumonitis, fatal disseminated trichosporonosis cases have recently been increasing. However, Trichosporon is often confused with other fungi, especially Candida , in pathological specimens. The aim was to determine the utility of histopathological stains and electron microscopy for diagnosing trichosporonosis. Methods and results: Autopsy cases of trichosporonosis, candidiasis, aspergillosis and cryptococcosis were investigated using histopathological stains and electron microscopy. Using Grocott’s method, Trichosporon was weakly detected compared with other fungi. In contrast, diluted periodic acid methenamine silver (PAM) stain clearly enhanced the intensity of staining of Trichosporon compared with Candida . Furthermore, Alcian blue and colloidal iron stains predominantly detected Trichosporon . Electron microscopy after staining with diluted PAM demonstrated that Trichosporon has a variety of hyphal sizes and laminar deposition of rough silver granules, whereas Candida has uniform pseudohyphae and fine granules. The average diameter and population area of the granules were significantly higher in Trichosporon compared with Candida ( P < 0.01). Meanwhile, the laminar structure was preserved in the cell walls of Trichosporon without silver stains, whereas a low‐density structure was observed in Candida . Conclusions: Histopathological staining patterns and electron microscopic findings can facilitate the diagnosis of trichosporonosis.