1993 Volume 32 Issue 4 Pages 567-572
A case of coccidioidomycosis detected in aspiration biopsy cytology of the neck is reported.
Our report aims to describe the morphological characteristics of Coccidioides immitis (C. immitis) spherules in cytologic preparations. The patient was a 35-year-old Japanese male who had returned from California, U. S. A.
Many spherules of C. immitis were observed in the purulent inflammatory background of the smear.
The spherules appeared orangeophilic to eosinophilic with Papanicolaou stain and were composed of a nonbudding spherical, thick-walled structure measuring 5 to μ jC in diameter. The spherules were round with double walls, and resembled pollen. Without awareness of coccidioidomycosis, therefore, they might be misidentified as pollen.
The mature spherules were filled with round, non-budding endospores, measuring 2 to 5μ in diameter. There were also a few free endospores in the smear. Some of the spherules exhibited the Splendore-Hoeppli effect, consisting of a hyaline, pale eosinophilic, radiating precipitate around the organisms.
Cytological examinations have been shown to be a useful tool for establishing the diagnosis.
Mycoses introduced into Japan from abroad have been increasing, making it appear that Japanese cytotechnologists and cytologists should know the morphological characteristics of C. immitis in the cytological material.
