Cryptococcus Neoformans: Lung
Cyrptococcus neoformans is an encapsulated yeast. This organism is an opportunistic infection
and primarily affects patients who are HIV positive or have full blown AIDS. This is the most
common predisposing factor. Organ transplant recipients, cancer patients receiving
chemotherapy, and long-time corticosteroid patients are also predisposing factors for infection.
Essentially any severely immunocompromised individuals could be potentially at risk. Pigeon
dropping are a common environmental source of exposure.
Cryptococcus neoformans organisms measure 5 to 20 µm and have a thick, gelatinous capsule.
A definitve dagnosis is difficult to make wiithout special stains.
Clinical History/Findings
The patient is a 65 year-old, HIV positive, Hispanic male with multiple lung masses presenting with
weight loss, fever, ascites, liver mass, and multiple enlarged celiac lymph nodes.
Specimen Type
A CT guided fine needle aspiration biopsy (FNAB) and core biopsy of a left lung mass was
performed.
Cytologic Findings
Cytologic Diagnosis:
Fungal organisms consistent with Cryptococcus Neoformans.
Submitted by:
Ann Marie West, BS, CT (ASCP)
Parkland Health & Hospital System
Dallas, Texas
Cyrptococcus neoformans is an encapsulated yeast. This organism is an opportunistic infection
and primarily affects patients who are HIV positive or have full blown AIDS. This is the most
common predisposing factor. Organ transplant recipients, cancer patients receiving
chemotherapy, and long-time corticosteroid patients are also predisposing factors for infection.
Essentially any severely immunocompromised individuals could be potentially at risk. Pigeon
dropping are a common environmental source of exposure.
Cryptococcus neoformans organisms measure 5 to 20 µm and have a thick, gelatinous capsule.
A definitve dagnosis is difficult to make wiithout special stains.
Clinical History/Findings
The patient is a 65 year-old, HIV positive, Hispanic male with multiple lung masses presenting with
weight loss, fever, ascites, liver mass, and multiple enlarged celiac lymph nodes.
Specimen Type
A CT guided fine needle aspiration biopsy (FNAB) and core biopsy of a left lung mass was
performed.
Cytologic Findings
Cytologic Diagnosis:
Fungal organisms consistent with Cryptococcus Neoformans.
Submitted by:
Ann Marie West, BS, CT (ASCP)
Parkland Health & Hospital System
Dallas, Texas
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Slide 1: Small, pale, round yeast
buds are present in histiocytes and
extracellularity. Without special
stains, the organisms are difficult to
see and morphologically differentiate
from other fungi. PAP Stain.
buds are present in histiocytes and
extracellularity. Without special
stains, the organisms are difficult to
see and morphologically differentiate
from other fungi. PAP Stain.
Slide 2: Diff Quick Stain more readily
identifies the cryptococcus organisms
then the Pap stain. Note the histiocyte
filled with the small encapsulated yeast
cells.
identifies the cryptococcus organisms
then the Pap stain. Note the histiocyte
filled with the small encapsulated yeast
cells.
Slide 3: Diff-Quik.
High-powered view of histocyte
engulfed cryptococcus neoformans.
High-powered view of histocyte
engulfed cryptococcus neoformans.
Slide 4: Grocott Stain:
Enhances the visualization of the
fungi and the morphology.
Single, tear drop-shaped budding
is characteristic of Cryptococcus
neoformans.
Enhances the visualization of the
fungi and the morphology.
Single, tear drop-shaped budding
is characteristic of Cryptococcus
neoformans.
| The Texas Society of Cytology |
Slide 5: Positive For Mucicarmine.
The mucoid capsule stains red with
mucicarmine
The mucoid capsule stains red with
mucicarmine
