scholarly journals Rhinosinusitis in an Australian mare caused by Flavodon flavus, a recently recognized invasive fungal pathogen of the horse

2019 ◽  
Vol 32 (1) ◽  
pp. 162-165
Author(s):  
Willy W. Suen ◽  
Steven Zedler ◽  
Rochelle Price ◽  
Tina Maguire ◽  
Catriona Halliday ◽  
...  

We describe herein the clinical, endoscopic, computed tomography (CT), pathologic, and microbiologic features of an infection caused by an under-recognized fungal pathogen, Flavodon flavus, in a 25-y-old Australian Quarter Horse. The horse had a unilateral obstructive nasal mass, resulting in stertor and dyspnea. On endoscopy, the mass was tan, multinodular, and completely obstructed the nasal passage. CT analysis revealed a large, soft tissue–attenuating and partially mineralized mass in the right nasal passage and dorsal-conchofrontal sinus, expanding into adjacent paranasal sinuses with associated bone lysis and rhinosinusitis. Histopathology of the mass on 2 occasions revealed suppurative inflammation initially, and pyogranulomatous inflammation subsequently. The inflammatory reaction surrounded numerous spherical fungal structures (~60–80 µm diameter) that stained positively on periodic acid–Schiff and Grocott methenamine silver stains. PCR for the fungal internal transcribed spacer 1 and 2 regions followed by Sanger sequencing on a cultured isolate identified the agent as F. flavus, which has only been reported previously as pathogenic in one horse in the United States, to our knowledge. Previous reports described this fungus as a nonpathogenic, environmental commensal fungus associated with insects and plants.

Author(s):  
Elia Shazniza Shaaya ◽  
Siti Atiqah Abdul Halim ◽  
Ka Wen Leong ◽  
Kevin Boon Ping Ku ◽  
Pei Shan Lim ◽  
...  

Background:Candida chorioamnionitis is rarely encountered, even though vulvovaginal candidiasis incidence is about 15%. Interestingly, it has characteristic gross and histological findings on the umbilical cord that are not to be missed. Case Report: We report two cases of Candida chorioamnionitis with presence of multiple yellowish and red spots of the surface of the umbilical cord. Microscopically, these consist of microabscesses with evidence of fungal yeasts and pseudohyphae. The yeasts and pseudohyphae were highlighted by periodic acid– Schiff and Grocott methenamine silver histochemical stains. Both cases were associated with a history of gestational diabetes mellitus. Discussion: Peripheral funisitis is a characteristic feature of Candida chorioamnionitis. It is associated with high risk of adverse perinatal and neonatal outcomes, such as preterm delivery, stillbirth and neonatal death. We recommend careful examination of the umbilical cord of mothers with gestational diabetes mellitus.


2018 ◽  
Vol 38 (7) ◽  
pp. 1394-1404
Author(s):  
Lorena F. Silva ◽  
Guilherme R. Blume ◽  
Rômulo S.A. Eloi ◽  
Jaqueline A. Lemos ◽  
Anahí S. Silva ◽  
...  

RESUMO: Mãos e pés de cães são comumente afetados por lesões neoplásicas e não neoplásicas. Estas alterações podem apresentar prognóstico histopatológico ou clínico ruim e a amputação tende a ser o tratamento de escolha. Estudos prévios avaliando a prevalência e os aspectos clínicopatológicos de alterações digitais em cães têm sido realizados em outros países, entretanto trabalhos similares não foram realizados no Brasil. O objetivo do presente estudo foi descrever e caracterizar histologicamente as lesões das mãos e pés de cães. Amostras de 105 lesões tumoriformes das mãos e pés de cães foram avaliadas. Essas amostras foram coletadas entre 2003 e 2016 e foram obtidas de três laboratórios brasileiros de diagnóstico veterinário. Todos espécimes foram fixados em formol tamponado 10%, processados rotineiramente e corados por hematoxilina-eosina. Adicionalmente, as colorações de azul de toluidina, Brown e Breen, periodic acid Schiff (PAS), Grocott Methenamine Silver (GMS) e Ziehl Neelsen foram utilizados em casos específicos. Imuno-histoquímica foi realizada usando os anticorpos anti-Leishmania spp., anti-CD117, anti-CD79, anti-CD3, anti-Melan A, anti-lisozima, anti-Pancytokeratin AE1/AE3 e anti-vimentina. Os neoplasmas (62,9%) foram as alterações mais frequentes, seguidas por inflamações (19%) e outras alterações (18,1%). Entre os neoplasmas, 40,9% foram mesenquimais, 39,4% epiteliais e 19,7% de células redondas. Todos os neoplasmas de células redondas e a maioria dos epiteliais e mesenquimais eram malignos. Não se observou predileção de prevalência dos neoplasmas em relação ao sexo. As raças Labrador Retriever, Schnauzer, Teckel, SRD, Pastor Alemão, Rottweiler e Pit Bull foram as mais afetadas. Fila Brasileiro, Pit Bull e Schnauzer tiveram alta incidência de neoplasmas mesenquimais, epiteliais e de células redondas, respectivamente. Inflamação foi mais comumente observada em cães Labrador Retriever e as outras alterações em Teckel, Labrador Retriever e SRD. A idade e o peso médio dos animais afetados foram de 8,4 anos e 28,5 kg, respectivamente. O diâmetro médio das lesões tumoriformes foi de 2,5 cm e as lesões neoplásicas apresentaram as maiores médias. As lesões ocorreram principalmente em animais de pelagem amarela. A maioria das biópsias incisionais (56,4%) e amputações (85,3%) consistiram de neoplasmas. O principal membro afetado foi o torácico direito e o dígito foi a estrutura anatômica acometida mais frequentemente. Carcinoma de células escamosas (14,2%) foi o neoplasma mais frequente, seguido do mastocitoma (7,6%), melanoma (7,6%) e sarcoma indiferenciado (7,6%). Em metade dos casos de inflamação, a lesão acometeu o folículo piloso e derme adjacente, e o infiltrado foi predominantemente piogranulomatoso ou lnfoplasmocítico. Cistos foliculares, calcinose circunscrita e acrocordoma foram as principais lesões não neoplásicas e não inflamatórias diagnosticadas.


2021 ◽  
Vol 14 (2) ◽  
pp. e240029
Author(s):  
Anirban Dutta ◽  
Sujata Das ◽  
Himanshu Sekhara Behera ◽  
Ruchi Mittal

A 61-year-old man presented with a 1-month history of reduced vision, redness and pain in the right eye. Examination revealed a bandage contact lens (BCL) in situ with diffuse, pigmented deposits. On removal, the underlying cornea was found to be clear. He had been prescribed the BCL 6 months ago following a deep-seated corneal foreign body removal and was unable to follow-up subsequently.The BCL was sent for microbiological and histopathological evaluation. The culture revealed growth of Cladosporium spp, a dematiaceous fungi. Periodic acid–Schiff staining revealed infiltration of pigmented fungal filaments into the substance of the BCL.While contact lens deposits are a frequent finding, fungal deposits are seldom noted. Irregular follow-up and improper lens maintenance are significant risk factors for the same. Early identification and subsequent removal of the lens is vital to prevent infection of the underlying ocular structures.


2020 ◽  
Vol 13 (2) ◽  
pp. e233020
Author(s):  
Pradeep Kumar Mada ◽  
Daniel Alexander Saldaña Koppel ◽  
Majd Al Shaarani ◽  
Andrew Stevenson Joel Chandranesan

Primary cutaneous aspergillosis (PCA) occurs through inoculation of fungal spores directly into the skin from the environment through disrupted skin such as in burns, surgery or penetrating trauma patients. Most cases reported in literature were in the immunocompromised, rarely in immunocompetent patients. The characteristic lesion of cutaneous aspergillosis is a black eschar on a red plaque, or nodule at the site of skin injury. The diagnosis of PCA can be made by identifying hyphal forms on routine H&E staining or special stains such as periodic acid-Schiff or Gomori methenamine-silver stains on skin biopsy and by fungal cultures. We report a case of an 80-year-old farmer who developed cutaneous aspergillosis after a surgical procedure without any systemic spread. The diagnosis was made by histopathology and tissue fungal cultures. He was treated with incision and drainage followed by oral voriconazole for 4 weeks; which led to clinical recovery.


Rare Tumors ◽  
2016 ◽  
Vol 8 (4) ◽  
pp. 169-172 ◽  
Author(s):  
Yusuke Takanashi ◽  
Shogo Tajima ◽  
Masaru Tsukui ◽  
Kazuya Shinmura ◽  
Takamitsu Hayakawa ◽  
...  

An extremely rare case of non-mucinous lepidic-predominant invasive adenocarcinoma (LPA) showing extensive aerogenous spread with a pneumonic presentation is reported. A 73-year-old woman was referred to our hospital because of an infiltrative shadow on chest xray. Chest computed tomography revealed extensive ground glass opacities in the right lower lobe, which was accompanied by infiltrative shadow with a pneumonic presentation. Invasive mucinous adenocarcinoma was presumed, and a partial resection of the right lower lobe was done. Histopathological examination revealed lepidic growth-predominant invasive adenocarcinoma with Clara type tumor cells, and there were innumerable aerogenous metastases also consisting of Clara cells. Because Alcian Blue and periodic acid-Schiff staining disclosed no mucus, the tumor was diagnosed as a non-mucinous LPA. The patient showed a poor response to 5 courses of pemetrexed, and she died one year after the diagnosis due to cancer progression. Nonmucinous LPA showed a rare presentation characterized by extensive aerogenous spread followed by a poor prognosis.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Yue Hu ◽  
Lin Zheng ◽  
Deng Pan ◽  
Lei Shao ◽  
Xianfa Xu ◽  
...  

In recent years, various biomarkers have been gradually applied on bronchoalveolar lavage (BAL) fluid for the diagnosis of invasive pulmonary aspergillosis (IPA). The objective of this study is to assess the value of the liquid-based cytopathology test (LCT) for improving the identification of IPA in BAL fluid from possible IPA patients, following special staining with periodic acid-Schiff staining (PAS) or Grocott’s methenamine silver (GMS). A total of 47 consecutive possible IPA patients who underwent bronchoscopy with BAL fluid from January 2017 to December 2018 were included. 45 people had a pair of BAL fluid specimens and 2 patients had two BAL fluid specimens. The 49 pairs of BAL fluid specimens were processed for culture, tuberculosis acid fast staining smear, direct microbial smear, and LCT with special staining (PAS and GMS), respectively. Then, we compared the sensitivity and specificity of PAS and GMS in BAL fluid in high-risk patients. Among 47 possible IPA patients, 25 patients had proven/probable IPA, and 11 patients had other invasive fungal diseases. The sensitivity of GMS was higher than that of PAS (92.11% versus 81.58%; P=0.175). The specificity of GMS was 81.82%, which was higher than that of PAS (81.82% versus 72.73%; P=0.611). The negative predictive value (NPV) for PAS and GMS were 53.33% and 75.00%, respectively. The positive predictive value (PPV) for PAS and GMS were 91.18% and 94.59%, respectively. This study showed that special staining of LCT in BAL fluid may be a novel method for the diagnosis of IPA, and the GMS of LCT had higher sensitivity and specificity, which was superior to PAS.


2009 ◽  
Vol 66 (8) ◽  
pp. 623-628 ◽  
Author(s):  
Biljana Radovanovic-Dinic ◽  
Vuka Katic ◽  
Aleksandar Nagorni ◽  
Ivanka Stamenkovic

Background/Aim. It is a general opinion that the biggest number of colorectal carcinoma (CRC) develops with the malignant alteration of colorectal adenomas (adenoma carcinoma sequence). Malignant potential of adenoma is in the function of its size, histological structure and the grade of dysplasia. An adequate analysis of colorectal adenomas helps their definition and timely removal, which significantly decreases carcinoma incidence. Mucin analysis can provide results which support the adenoma carcinoma sequence theory. The aim of the study was to present histochemical characteristics of adenomas and emphasize the significance of these analyses for the precise adenoma definition. Methods. This prospective study included analysis of 117 colorectal adenomas obtained by transcolonoscopic biopsy or polipectomy in 82 patients. The biopsy samples and the removed polyps were coloured by hematoxilin-eozin (HE) staining and histochemical stainings by Periodic Acid Schiff (AB-PAS) and High Iron Diamine/Alcian blue (HIDAB; pH=2.5) to prove mucins. Results. Sulphomucins are more often found in adenomas of the left colon than of the right one (p < 0.001). Sialomucins are more reactive in adenomas of the right colon (p < 0.001). Sulphomucins are more reactive in adenomas of < 10 mm diameter (p < 0.05). The reactivity of all mucins is in negative correlation with the degree of dysplasia (p < 0.001). There is a significant difference in the reactivity of sialomucins in adenomas of the same histological type but different degree of dysplasia (?2 = 25,743, df = 6, p < 0.001). Conclusion. The difference in the presence of mucins between adenomas of the left and right colons supports the theory of adenoma carcinoma sequence, since adenomas of the right colon are more protected by sialomucins and therefore less malignantly altered, which is consistent with CRC topography. Histochemical analysis of colorectum is significant for more accurate gradation of dysplasia and confirmation of malignant alteration. The negative correlation between the degree of dysplasia and the production of mucin indicates the significance of the degree of dysplasia in malignant potential of colorectal adenomas.


2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S73-S73 ◽  
Author(s):  
Luke Cypher ◽  
Shaoli Sun ◽  
Erin Forster ◽  
Brenda Hoffman ◽  
David Lewin

Abstract Introduction There were an estimated 18.1 million new cancer cases in 2018, with colon cancer being the third most common worldwide. Colon cancer development is an accumulation of mutations resulting in normal epithelial cells transforming into adenomas and then adenocarcinomas. In certain scenarios, endoscopic interventions have gained considerable momentum over invasive surgery as an alternative to manage early gastrointestinal lesions. New techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection allow for removal of large, flat sessile polyps. Successful EMR is dependent on expanding the submucosal space to create adequate lift of the polyp to facilitate tissue capture and to avoid perforation and excess bleeding. ORISE gel (Boston Scientific) is a submucosal lifting agent currently in use in the United States. Methods We present three cases of gastrointestinal specimens obtained using ORISE gel. Histological analysis with hematoxylin and eosin revealed submucosal amorphous deposits that appeared to be mucin. Due to the concern for malignancy, additional stains were performed, including periodic acid–Schiff with diastase digestion (DPAS) to identify mucin. DPAS staining for mucin was negative, indicating the mucinous-appearing amorphous material seen on hematoxylin and eosin staining was not mucin but a likely remnant ORISE gel used during EMR. Additional immunohistochemical stains for epithelial cells (cytokeratin AE1/AE3) were also performed to exclude the presence of infiltrating tumor cells. Conclusion These three cautionary cases reveal the importance of good communication between endoscopists and pathology. In an effort to avoid overdiagnosis and/or the usage of unnecessary additional stains, pathologists should be alerted of ORISE gel usage.


2003 ◽  
Vol 13 (5) ◽  
pp. 482-485 ◽  
Author(s):  
E. Mencía-Gutiérrez ◽  
E. Gutiérrez-Díaz ◽  
J.R. Ricoy ◽  
B. Sarmiento-Torres

Purpose To report a case of congenital phakomatous choristoma (PC) of the eyelid, a rare tumor of lenticular anlage in the subcutaneous tissue and dermis. Case A boy had a mass in the right lower eyelid near the inner canthus at birth. At age 10 months, the tumor was excised. Results The tumor cells showed intense immunoreactivity positive for S-100 protein, vimentin, and periodic acid-Schiff. Keratin markers, epithelial membrane antigen, glial fibrillary acidic protein, muscle specific actin, and epithelial membrane antigen were negative. The histopathologic features were consistent with those of a PC. Conclusions This histopathologic and immunoreactivity study supports the proposal that PC is a rare entity of lenticular anlage origin. Only 18 such cases have been described previously.


1993 ◽  
Vol 41 (8) ◽  
pp. 1217-1221 ◽  
Author(s):  
J A Reed ◽  
B A Hemann ◽  
J L Alexander ◽  
D J Brigati

We report the rapid (less than 1 hr), immunocytochemical identification of various fungi in formalin-fixed, paraffin-embedded tissues using antisera originally developed for use in immunodiffusion assays. Primary antisera directed towards fungal genera including Aspergillus, Blastomyces, Candida, Coccidioides, Cryptococcus, Histoplasma, and Sporothrix were examined. The specificity of each antiserum was evaluated by the presence or absence of crossreactivity with other morphologically similar fungi in both paraffin-embedded pure fungal cultures and tissues with culture-confirmed fungal infections. Each antiserum reacted strongly with the fungus to which it had been raised, whether examined in pure culture or infected tissues. The antisera raised against Candida, Cryptococcus, and Sporothrix did not exhibit cross-reactivity with any other fungus tested. However, the antisera raised to Aspergillus, Blastomyces, Coccidioides, and Histoplasma demonstrated significant crossreactivity with other genera of fungi, thus precluding their routine use in diagnostic immunocytochemistry. The results indicate that immunocytochemistry may provide an important adjunct to other methods, such as immunodiffusion or complement fixation assays and histochemical stains such as the Grocott methenamine silver or periodic acid-Schiff, when attempts are made to specifically identify certain fungi in formalin-fixed, paraffin-embedded tissues before mycology culture results are available.


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