FNA of thoracic mass: South American Blastomycosis (Paracoccidioides brasiliensis)


Drs. Prolla and Diehl's INTERESTING CASE OF THE MONTH August 2002 Case B
200x and 500x M-G-G staining, see the giant cell with intracellular yeast form

500x M-G-G staining, extra-cellular yeast elements

500x M-G-G staining, giant cell with intracellular yeast elements

Gomori silver stainings:
500x Gomori silver staining, round budding yeasts, of variable size, refractile walls.

500x Gomori silver staining, round budding yeasts, of variable size, refractile walls.

KOH preparation:
500x KOH preparation, round budding yeast with the ship's wheel appearance
The M-G-G stained smears show many giant cells which contain the round organisms with refractile walls. The fungus occurs as a budding yeast with cells 18-24 um in diameter, but some are quite large (over 40-60 um), and many extracellular fungi are present. The Gomori staining ( see pictures above) and the cultures confirmed the diagnosis. The KHO preparation demonstrates the characteristic "ship's wheel" morphology of the budding yeast. This case is remarkable due to the sex of the patient: the chronic adult form affects men more frequently than women, with a ratio of about 15:1.


References List of cases Atlas
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