S11C16P11-Fungus Diseases

S11C16P11-1: A defect in the tissue contains neutrophils, histiocytes, and lymphoid cells; it has suppurative qualities. In the center of the field (red arrows), rounded organisms are clustered; they have doubly contoured walls. The organisms have pulled away from their cell-wall to produce a clear zone. They are heavily stained with hematoxylin. The size and structure of the organisms are features favoring a diagnosis of blastomycosis.

S11C16P11-2: This is a characteristic pattern for a cutaneous lesion of blastomycosis. Hyperplastic, pale, squamous epithelium extends into the dermis in the pattern of pseudoepitheliomatous hyperplasia.(blue arrows). At the margins of the columns of epithelial cells, there are dense infiltrates of acute and chronic inflammatory cells.

S11C16P11-3: Most deep fungus infections and atypical acid-fast infections are manifested in patterns of a suppurative granuloma. The patterns of such a lesion are represented in this field. There is an area of suppuration centrally. In this example of a suppurative granuloma, organisms, compatible with those of blastomycosis, are suspended in the pus. Centrally, a budding organism has a broad base (a feature in keeping with an organism of  blastomycosis). At the top of the field, there is a thin row of epithelioid histiocytes; the combination of granulomatous and suppurative patterns qualifies the lesion as a suppurative granuloma.

S11C16P11-4: The lesion is suppurative, and granulomatous. The pigmented organisms in the clusters show some degree of pleomorphism (chromomycosis).

S11C16P11-5: At higher magnification, the organisms are deeply pigmented. The pigment is melanotic; it has an affinity for silver with a Fontana-Masson stain. Septate forms are represented.

S11C16P11-6: This is another example of chromomycosis. The organisms are pigmented and some are septated.

S11C16P11-7: The basic pattern of inflammation in this field is that of a granuloma. Epithelioid histiocytes form solid aggregates. The rounded organism centrally is larger than the usual examples of organisms in a lesion of blastomycosis; it has an affinity for hematoxylin comparable to that of the organisms of blastomycosis, but the internal structure is distinctive; the “chromatin” of the organism is arranged around clear spaces that are fairly uniform in size. The internal patterns are compatible with endosporulation; endosporulation is a feature of the organisms of coccidiodomycosis.

S11C16P11-8 a&b: On the left in a lesion of coccidioidomycosis, there is a budding organism (narrow based bud). On the right near the bottom of the field, there is an empty cell (cyst) wall. Endospores have been released, but the cyst wall remains.

 

UP TO TEXTUAL LEVEL, IF AT PICTORIAL LEVEL (3), OR TO HOME IF AT TEXTUAL LEVEL (2)

BACK IN SPATIAL SEQUENCE ALONG TIER

Beige buttons to the right are a continuation of the vertically oriented beige cluster above. The mauve buttons provide access to other SECTIONS on this site.

NEXT CHAPTER IN SEQUENCE, IF AT EITHER LEVEL 2 OR LEVEL 3