犬小孢子菌致体癣1例

报道1例由犬小孢子菌引起的体癣。患者,女,27岁,因前额、颈部多发环状红斑2周就诊。经真菌培养确诊为犬小孢子菌感染所致的体癣。予特比萘芬、灰黄霉素搽剂（商品名“止霉舒搽剂”）外用1周后痊愈。     

Disease progression of dermatophytic pseudomycetoma in a Persian cat

BackgroundDermatophytic pseudomycetoma is a subcutaneous fungal infection by Microsporum canis.AimsThis work describes a case of dermatophytic pseudomycetoma in a Persian cat.Patient and methodsA 3-year old female Persian cat showing alopecia, scaling and ulcerated nodules throughout the body, with presence of ulcerated nodules with yellow granular discharges on the dorsum, close to the tail. Mycological and histopathological examinations were realized.ResultsDiagnosis of dermatophytic pseudomycetoma was established. The cat was treated with griseofulvin, and surgical excision was carried out. Response to therapy was effective during the first months, during which a reduction in nodule frequency was observed. However, despite maintaining the therapy levels, the lesions relapsed and progressed to the point of causing the animal's death.ConclusionThe clinic evolution showed the progressive and recurrent character of dermatophytic pseudomycetoma.     

宠物猫致夫妻共患犬小孢子菌体癣

报道由犬小孢子菌引起的人畜共患体癣2例,二者系夫妻,家中饲养宠物猫。因多发环状红斑2周就诊。取患者及猫的皮屑真菌镜检及培养,鉴定为须癣毛癣菌,经口服及外用抗真菌药物后治愈。     

Fine needle aspiration biopsy of neuroendocrine breast carcinoma metastatic to the thyroid. A case report

BACKGROUND: Tumors showing neuroendocrine differentiation arise in a wide range of organs, and metastatic neuroendocrine tumors may be difficult to differentiate from primary tumors. This report describes an unusual case of metastatic breast carcinoma with neuroendocrine differentiation that presented as a solitary thyroid nodule. The diagnosis was made by fine needle aspiration biopsy (FNAB). CASE: A 52-year-old woman presented with a thyroid nodule and bilateral enlarged supraclavicular fossa lymph nodes. FNAB revealed a neuroendocrine carcinoma. Further questioning revealed that the patient had had a breast carcinoma resected eight years previously. The diagnosis of metastatic neuroendocrine breast carcinoma was established by immunocytochemistry. The patient received antiestrogen therapy but subsequently developed skeletal metastases. CONCLUSION: Neuroendocrine carcinomas from various sites show similar cytologic features. In this case, a diagnosis of breast carcinoma metastatic to the thyroid was suggested by the clinical history and confirmed by FNAB with immunocytochemistry.     

Histopathological diagnosis of mycoses in veterinary pathology

Histopathological analysis demonstrates the morphology of the fungi and shows their relationship with tissue lesions, which is a valuable information in the diagnosis of veterinary mycoses, especially in superficial infections where reservoirs make difficult the diagnosis using other techniques. On the other hand, histopathological analysis should be complementary to other methods such as culture, immunohistochemistry, serology, PCR, etc. In this work, the most relevant histopathological features of some of the most common mycoses of domestic animals, some of which have zoonotic potential, are described and their differential diagnosis is discussed. To facilitate the discussion of the differential diagnoses, mycoses have been grouped by the sites of the infections and by the nature of the fungi (dimorphic and filamentous). Mycoses included in the study were 1) Superficial and deep infections: dermatophytosis, dermatophytic pseudomycetoma, eumycotic mycetoma, phaeohyphomycosis and malasezziasis. 2) Systemic mycoses: aspergillosis and zygomycosis. 3) Mycoses due to dimorphic fungi: candidiasis, cryptococcosis, blastomycosis, sporotrichosis, coccidioidomycosis and histoplasmosis. 4) Infections by algae and other fungi: protothecosis and pneumocystosis.     

Diagnosis of cervical thymoma by fine needle aspiration biopsy with flow cytometry. A case report

BACKGROUND: Cervical thymoma is a rare entity. To our knowledge, this is the 20th reported case of cervical thymoma and the fourth case of fine needle aspiration biopsy (FNAB) of this entity. To our knowledge, this is the only case in which cervical thymoma was a diagnostic consideration at the time of the FNAB diagnosis. The diagnosis was rendered because, unlike in previous cases, flow cytometric immunophenotyping was performed. CASE: A 46-year-old, white female presented with what was clinically thought to be a left thyroid nodule. The patient underwent FNAB at an outside institution, and the diagnosis of "possible mixed lymphoma" was made by morphology alone. The patient was referred to our institution for repeat FNAB. Based upon the cytologic findings (cells with lymphoid morphology), flow cytometry was performed, and a diagnosis of cervical thymoma (versus ectopic thymic tissue) was based upon flow cytometry findings combined with morphology. CONCLUSION: When FNAB of a cervical mass, particularly one clinically thought to be a thyroid nodule, shows lymphoid cells without thyroid follicular cells, immunophenotyping may be extremely helpful in arriving at the correct diagnosis.     

Fine needle aspiration biopsy in central giant cell lesion: a report of 3 cases

BACKGROUND: Fine needle aspiration biopsy (FNAB) is a safe and efficient diagnostic method used in numerous lesions of the head and neck region. However, its use in central giant cell lesion (CGCL) is rarely seen. CASES: Three cases of CGCL were initially diagnosed with FNAB, emphasizing the cytologic and immunocytochemical features. CONCLUSION: FNAB, particularly when associated with clinical, radiographic and laboratory examinations, plays an important role in the preliminary diagnosis of CGCL.     

Tall cell variant of papillary carcinoma coexisting with chronic lymphocytic thyroiditis. A case report.

BACKGROUND: Recent studies have shown a correlation between lymphocytic thyroiditis and papillary carcinoma of the thyroid. It is thought that autoimmune thyroiditis could be a risk factor for the development of thyroid carcinoma, mainly for the papillary variant. CASE: A 59-year-old female presented with a history of enlargement in the neck and five months of dysphagia. Clinical examination showed generalized expansion and an increase in the hardness of the thyroid gland. Hormonal outline showed subclinical hypothyroidism with serum levels of TSH slightly elevated (5 micrograms/dL; range, 0.25-4). Thyroglobulin antibodies and thyroperoxidase titers were moderately positive. Given these results, a diagnosis of chronic thyroiditis was made. Thyroid ultrasound scan showed diffuse gland irregularity and the presence of a solitary nodule (2.3 cm in diameter) localized in the right lobe. Fine needle aspiration biopsy (FNAB) of the nodule was performed under ultrasound guidance. CONCLUSION: Although clinical and laboratory results supported the diagnosis of autoimmune thyroiditis only, FNAB of the nodular lesion provided evidence of a rare case of papillary carcinoma, tall cell variant, confirmed by histologic results.     

Fine-needle aspiration biopsy cytology of cutaneous calcinosis in a 74-year-old woman with dermatomyositis on methotrexate therapy: a case report

BACKGROUND: Cutaneous calcinosis (CC) occurs in a variety of rheumatic diseases. Fine needle aspiration biopsy (FNAB) may be used in the office setting to evaluate such soft tissue lesions. For patients on methotrexate (MTX) therapy, methotrexate nodulosis (MN) should be considered in the differential diagnosis. CASE: A 74-year-old Caucasian woman with adult-onset dermatomyositis (ADM) on MTX therapy presented for evaluation of a right breast mass and multiple soft tissue nodules. FNABs of the right breast mass and a left upper extremity nodule both demonstrated benign calcified material. Six months later, the patient returned for evaluation of the persistent right breast mass and repeat FNAB revealed adenocarcinoma. Concurrently, a right hip soft tissue nodule was aspirated, demonstrating benign crystalline debris. MTX therapy was discontinued, and the patient subsequently underwent a lumpectomy of the right breast 1 month after FNAB diagnosis, displaying infiltrative ductal carcinoma. Of note, 2 months after her lumpectomy, MTX therapy was restarted and the patient continues to have adequate control of ADM symptoms with persistent, clinically benign soft tissue calcifications. CONCLUSION: Performing FNAB on soft tissue lesions can obviate needless tissue biopsies of CC in appropriate rheumatology patients, thus avoiding the risks and complications associated with more invasive procedures.     

Intravenous pyogenic granuloma mimicking pleomorphic adenoma in a fine needle aspirate. A case report.

BACKGROUND: Intravenous pyogenic granuloma (IvPG) is a rare, benign lesion occurring usually as a subcutaneous mass in the neck or upper extremity. The cytologic features of IvPG have not been described before. CASE: A patient presented with a subcutaneous nodule on the lower border of the left parotid area. The clinical diagnosis was bronchial cleft cyst or lymphadenitis, and the fine needle aspiration diagnosis was pleomorphic adenoma. The tissue section, however, disclosed IvPG. CONCLUSION: Evaluation of subcutaneous nodules presenting cytologically as spindle cell lesions may be problematic, particularly in the neck and head region. Such lesions occurring in the parotid area may be interpreted as pleomorphic adenoma of the salivary gland.     

Fine needle aspiration biopsy of mixed medullary-follicular thyroid carcinoma. A report of two cases

BACKGROUND: Mixed differentiated thyroid carcinomas are rare tumors, difficult to recognize on fine needle aspiration biopsy (FNAB). Most cases are diagnosed only after histologic investigation. CASES: The cases entailed two cytologic samples and a thyroidectomy specimen. Two FNAB thyroidectomy specimens from a 60-year-old man presenting with a solitary thyroid nodule (case 1) were investigated. Both cytologic samples were referred as atypical, with a mixture of features indicating a proliferating follicular lesion but also containing some characteristics of medullary carcinoma. The serum calcitonin level was borderline. Surgery was recommended because of a suspicion of malignancy. The diagnosis of mixed medullary follicular carcinoma was established after a complex histologic investigation. The tumor was encapsulated, with partly microfollicular architecture. Immunohistochemistry was positive for both calcitonin and thyreoglobulin. Electron microscopy from the formol-paraffin block found neurosecretory granules in many cells. The patient was well one year after the operation. One FNAB and thyroidectomy specimen from a 47-year-old woman with long-treated lymphoplasmocellular thyroiditis (case 2) was investigated. The tumor in case 2 was diagnosed on FNAB as medullary carcinoma. Only after histologic and immunohistochemical investigation was mixed differentiation proven. CONCLUSION: Mixed differentiated thyroid tumors are a diagnostic challenge on fine needle aspiration. Irrespective of their rarity, they can be suspected if combined features are present. FNAB recognition of the medullary component in both cases was of crucial importance. Nevertheless, definitive diagnosis remains a histologic problem due to the necessity for topographic information.     

The mycoses of Oceania

A review of the mycoses of Oceania, defined as the Pacific islands of Melanesia, Micronesia and Polynesia, has revealed the occurrence of cutaneous, subcutaneous and systemic mycoses.Tinea versicolor is the most prevalent of the cutaneous mycotic infections. Dermatophyte infections are also common. The etiologic agents incriminated have beenEpidermophyton floccosum, Microsporum canis, members of theMicrosporum fulvum-gypseum complex,Trichophyton concentricum, T. mentagrophytes, T. rubrum, T. tonsurans andT. verrucosum. Only one case of tinea nigra has been reported and that was in Hawaii. Among the fungi that cause subcutaneous mycoses onlyAllescheria boydii, Nocardia brasiliensis, Madurella mycetomi andSporothrix schenckii have been encountered to date. Among the systemic mycoses, actinomycosis, cryptococcosis and histoplasmosis have been found to be present. The geographic distribution of these actinomycotic and mycotic infections is provided along with data on soil isolation records and histoplasmin sensitivity surveys.Paper presented at the Symposium on Microbiology, Canadian Medical Expedition to Easter Island, Montreal, April 26–28, 1971     

Updates on the Epidemiology of Dermatophyte Infections

The spectrum of dermatophytes isolated from skin lesions had changed in last 70 years. Before the Second World War in Germany, Microsporum audouinii and Epidermophyton floccosum ranked the first, whereas Trichophyton rubrum is the most common dermatophyte since the fifties of last century, accounting for 80-90% of the strains, followed by T. mentagrophytes. This evolution is typical for Central and North Europe and it needs to be connected with the increase in the incidence of tinea pedis. In contrast, in Southern Europe and in Arabic countries, zoophilic dermatophytes, such as Microsporum canis or Trichophyton verrucosum, are the most frequently isolated. In Europe, especially in Mediterranean countries, the incidence of M. canis infection has strongly increased during the recent years and this dermatophyte is now the most prevalent in tinea capitis in children. An analysis of the frequency and distribution of tinea pedis in different occupations and leisure-time activities as well as the routes of infection are reported. The spreading of this disease in most developed countries of the world represents a considerable economic problem, since it was accompanied by a parallel increase in the frequency of onychomycosis which implies, as tinea pedis, large financial charges. In poor developing countries, mycoses appear endemically, primarily with children, and their treatment often fails because of the lack of efficient antifungals. The particular epidemiological situations of dermatophytoses and the pathogenic spectrum of dermatophytes are examined at the example of numerous countries.     

Unusual cases of metastases to the breast. A report of 17 cases diagnosed by fine needle aspiration

BACKGROUND: Although nonmammary tumors metastatic to the breast are relatively uncommon, a correct diagnosis is essential to appropriate management. Radiologically these lesions are single, round, discrete lesions without the spiculations of primary malignancies. Fine needle aspiration biopsy (FNAB) may provide a definitive diagnosis, thereby sparing patients unnecessary surgery. CASES: Seventeen cases of nonmammary malignancies diagnosed by fine needle aspiration of the breast were identified in the cytopathology files at three different institutions from 1989 to 1999. Three of the cases are of particular interest, including a mucoepidermoid carcinoma of salivary gland origin and a small cell undifferentiated carcinoma of rectal origin, neither of which has been reported in the literature previously. The third case was a male with a breast mass that was originally thought to be primary based on clinical, cytologic and immunocytochemical features but subsequently was determined to be a metastasis from the lung. CONCLUSION: Virtually any malignancy may metastasize to the breast. FNAB is the best approach to the diagnosis of tumors that either clinically or radiographically are not typical of primary breast tumors. Extramammary neoplasms metastatic to the breast may be definitively diagnosed by FNAB, resulting in the most appropriate as well as cost-effective patient management.     

Human mycoses in Portugal [1960–1973]

A critical survey is made of human mycoses diagnosed in European Portugal and in the Portuguese Overseas Provinces. Dermatophyte infections and pityriasis versicolor are commom in the entire territory. The more frequently isolated dermatophytes in Continental Portugal wereTrichophyton violaceum, Microsporum canis, Trichophyton tonsurans andTrichophyton schoenleinii, in the scalp andTrichophyton rubrum, Trichophyton mentagrophytes, Trichophyton megninii andEpidermophyton floccosum in the other body sites. In the Overseas Provinces the species found in white people were very much the same, whereas in negroes mainlyMicrosporum audouinii andT. violaceum in Mozambique,M. audouinii in Angola, andTrichophyton soudanense, M. audouinii andT. rubrum in Guinea were identified.In Continental Portugal cases of candidiasis, mycetoma, aspergillosis, sporotrichosis and cryptococcosis were described in patients who had never been outside Europe; and tinea nigra, African histoplasmosis and South-American blastomycosis in individuals who live or lived in India, Africa and Brazil.The first case of North-American blastomycosis was reported in Mozambique.     

Cytodiagnosis of lymphoid proliferations by fine needle aspiration biopsy. Adjunctive value of flow cytometry

OBJECTIVE: To determine the accuracy of fine needle aspiration biopsy (FNAB) complemented by flow cytometry (FC) for the diagnosis of reactive and neoplastic lymphoid proliferations and subclassification of malignant lymphomas. STUDY DESIGN: Forty-one FNABs of lymphoid lesions on which FC had been performed were evaluated retrospectively. All cases were correlated with histology or clinical follow-up. RESULTS: Twelve FNABs were diagnosed as reactive. Eleven of the 12 were confirmed as reactive on follow-up. One was a case of posttransplant lymphoproliferative disorder. Twenty-five FNABs diagnosed as lymphoma were confirmed by histology. In 22 of these 25 cases, there was 100% correlation between the subclassification given on FNAB with FC and that given on histology. Two of the remaining cases, which were correctly called follicular center cell lymphoma, showed discrepancies in grading. One case called Hodgkin's disease on FNAB was T-cell lymphoma on histology. Of four FNABs given an inconclusive diagnosis, two were lymphoma on follow-up, and two were reactive. CONCLUSION: FNAB examination, when it includes immunophenotyping by FC, is a useful technique for distinguishing reactive lymphoid proliferations from malignant lymphomas and for the subclassification of lymphomas.     

30例犬小孢子菌致体癣病例的临床分析

目的 通过对30例犬小孢子菌致体癣病例的临床分析,探讨城市犬小孢子菌病的常见感染来源及防治方案.方法 收集2012年6～7月就诊于我院有宠物接触史(猫、狗)的体癣患者30例,对其致病菌种做真菌培养鉴定,对结果进行临床分析.给予患者外用联苯苄唑软膏或特比萘芬软膏治疗.结果 30例患者均在发病前接触过猫或狗,病程不长,真菌培养结果显示均为犬小孢子菌,经治疗后均痊愈.结论 30例犬小孢子菌致体癣患者皮损特征相似,外用抗真菌软膏可得到有效治疗.     

Mycetes and urban areas

Mycetes are ubiquitous organisms that can cause mycoses in human and animals. The role of animals in the epidemiology of human mycoses in urban areas is multiform, but here will be discuss only two features: A) animals as vectors of mycoses and B) animal substrates as growth factor of pathogenic fungi. A) Animals as vectors of mycoses: this role is important as zoofilic dermatophytes are very important agents of zoonosis; the urban dermatophytozoonoses are prevalent caused by Microsporum canis which is prevalent in cats and dogs. Cats are often asymptomatic carriers. The pattern of human dermatomycoses has changed in Italy during the past century: at the beginning of the century anthropophilic fungi were prevalent while at present the zoophilic fungi are the most important causes. B) Animal substrata as growth factor of pathogenic fungi: soil "animalization" (i.e., the addition of such debris as hair, skin scales, dropping and other organic matters) creates an optimal substratum for the growth and the multiplication of geophilic or saprophyitic fungi, such as Microsporum gypseum and Cryptococcus neoformans. The present human lifestyle, which favours a an overpopulation of birds, wild animals, domestic mammals and sinanthropic together with man in crowded areas seems to favour the formation of environments adapted to the abundant growth of some pathogenic fungi with consequent infection for man and animals. Finally, an environment heavily populated by fungi can cause allergic pulmonary reactions as well as reactions in other organs and tissues. The control of human and animal fungi, and the efficient use of a monitoring system require ample knowledge of mycological problems both in human and veterinary medicine and of efficient laboratories capable of resolving the needs of both disciplines. Close collaboration between veterinarians, doctors and mycologists is necessary in order to resolve health problems linked to mycosis.     

脓癣伴急性丹毒样癣菌疹1例

报道1例由脓癣引起的急性丹毒样癣菌疹。患者女,68岁,因头皮多发性脓肿伴四肢肿痛入院。头发及脓痂真菌直接镜检阳性,真菌培养为犬小孢子菌。经口服伊曲康唑等药物治疗皮疹基本消退。     

Fine needle aspiration cytology in lymphadenopathy of HIV-positive cases

OBJECTIVE: To evaluate the role of fine needle aspiration biopsy (FNAB) material in 25 HIV-positive cases with lymphadenopathy. STUDY DESIGN: We selected 25 cases for the present study who were enzyme-linked immunosorbent assay positive for HIV (HIV-1). FNAB was performed as a routine, outdoor procedure with informed consent of the patient. For each case, along with routine May-Grünwald-Giemsa and hematoxylin and eosin staining, Ziehl-Neelsen staining for acid-fast bacilli and periodic acid-Schiff staining for fungi were performed wherever necessary. RESULTS: A total of 28 sites were aspirated from 25 HIV patients. All these patients were heterosexual, and none had a history of drug abuse. FNAB was performed under ultrasound guidance in all four cases of a retroperitoneal group of lymph nodes. The most common FNAB diagnosis was reactive lymphoid hyperplasia (10), followed by tuberculosis (8). There were three cases diagnosed as fungal infection (two, Cryptococcus; one, histoplasmosis). FNAB of a case of lymph node was suggestive of tuberculosis. There was one case each diagnosed as non-Hodgkin's lymphoma and squamous cell carcinoma (metastatic). One case of a small axillary lymph node did not yield representative material. CONCLUSION: FNAB is a relatively inexpensive initial investigative technique in the diagnosis and management of HIV-positive patients. It can obviate the need for surgical excision and enable immediate treatment of specific infections.