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[[Image:Pulmonary aspergillosis.jpg|thumb|right|280px|Fungi (aspergillus). [[H&E stain]].]] | |||
'''Fungi''' (singular '''fungus''') are [[microorganisms]] that are occasionally seen by pathologists. | '''Fungi''' (singular '''fungus''') are [[microorganisms]] that are occasionally seen by pathologists. | ||
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*[[Mucor]]. | *[[Mucor]]. | ||
*[[Aspergillus]]. | *[[Aspergillus]]. | ||
===Sign out=== | |||
*The gold standard for determining the microorganisms is culture. | |||
*As anatomical pathologists are approximately 80% accurate (when measured against culture), it is important to state something like ''correlation with culture is recommended''.<ref name=pmid19228642>{{Cite journal | last1 = Sangoi | first1 = AR. | last2 = Rogers | first2 = WM. | last3 = Longacre | first3 = TA. | last4 = Montoya | first4 = JG. | last5 = Baron | first5 = EJ. | last6 = Banaei | first6 = N. | title = Challenges and pitfalls of morphologic identification of fungal infections in histologic and cytologic specimens: a ten-year retrospective review at a single institution. | journal = Am J Clin Pathol | volume = 131 | issue = 3 | pages = 364-75 | month = Mar | year = 2009 | doi = 10.1309/AJCP99OOOZSNISCZ | PMID = 19228642 }}</ref> | |||
==Summary table== | ==Summary table== | ||
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**Usu. from soil. | **Usu. from soil. | ||
*Typical locations: lung, oral cavity.<ref name=Ref_WMSP3>{{Ref WMSP|3}}</ref> | *Typical locations: lung, oral cavity.<ref name=Ref_WMSP3>{{Ref WMSP|3}}</ref> | ||
*+/-Immunodeficiency.<ref name=pmid23824371>{{Cite journal | last1 = Nguyen | first1 = C. | last2 = Barker | first2 = BM. | last3 = Hoover | first3 = S. | last4 = Nix | first4 = DE. | last5 = Ampel | first5 = NM. | last6 = Frelinger | first6 = JA. | last7 = Orbach | first7 = MJ. | last8 = Galgiani | first8 = JN. | title = Recent advances in our understanding of the environmental, epidemiological, immunological, and clinical dimensions of coccidioidomycosis. | journal = Clin Microbiol Rev | volume = 26 | issue = 3 | pages = 505-25 | month = Jul | year = 2013 | doi = 10.1128/CMR.00005-13 | PMID = 23824371 }}</ref> | |||
*Predominantly southwest USA and Mexico.<ref name=pmid23068145>{{Cite journal | last1 = Welsh | first1 = O. | last2 = Vera-Cabrera | first2 = L. | last3 = Rendon | first3 = A. | last4 = Gonzalez | first4 = G. | last5 = Bonifaz | first5 = A. | title = Coccidioidomycosis. | journal = Clin Dermatol | volume = 30 | issue = 6 | pages = 573-91 | month = | year = | doi = 10.1016/j.clindermatol.2012.01.003 | PMID = 23068145 }}</ref> | |||
===Microscopic=== | ===Microscopic=== | ||
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*"Dented ping-pong ball" appearance.<ref name=Ref_WMSP103>{{Ref WMSP|103}}</ref> **Remember '''P'''C'''P''' = '''p'''ing-'''p'''ong. | *"Dented ping-pong ball" appearance.<ref name=Ref_WMSP103>{{Ref WMSP|103}}</ref> **Remember '''P'''C'''P''' = '''p'''ing-'''p'''ong. | ||
**Approximately 7-8 μm in size. | **Approximately 7-8 μm in size. | ||
DDx: | |||
*[[Pulmonary alveolar proteinosis]]. | |||
====Images==== | ====Images==== | ||
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www: | www: | ||
*[http://commons.wikimedia.org/w/index.php?title=Special%3ASearch&search=Pneumocystis+carinii&go=Go Several images of PCP (WC)]. | *[http://commons.wikimedia.org/w/index.php?title=Special%3ASearch&search=Pneumocystis+carinii&go=Go Several images of PCP (WC)]. | ||
===Stains=== | ===Stains=== | ||
*[[GMS stain]] +ve. | *[[GMS stain]] +ve. | ||
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*May be confused with corpora amylacea in the CNS, esp. as they (like cryptococci) stain for methenamine silver, Alcian blue, and PAS.<ref>URL: [http://flylib.com/books/en/2.953.1.17/1/ http://flylib.com/books/en/2.953.1.17/1/]. Accessed on: 15 December 2010.</ref> | *May be confused with corpora amylacea in the CNS, esp. as they (like cryptococci) stain for methenamine silver, Alcian blue, and PAS.<ref>URL: [http://flylib.com/books/en/2.953.1.17/1/ http://flylib.com/books/en/2.953.1.17/1/]. Accessed on: 15 December 2010.</ref> | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Cryptococcus.jpg | Cryptococcosis - cytology - [[Field stain]]. (WC) | |||
Image:Cryptococcosis_of_lung_in_patient_with_AIDS._Mucicarmine_stain_962_lores.jpg | Crytococcosis - mucicarmine stain. (WC) | |||
Image:Cryptococcosis_of_lung_in_patient_with_AIDS_Methenamine_silver_stain_963_lores.jpg | Crytococcosis - methenamine silver stain. (WC) | |||
</gallery> | |||
www: | |||
*[http://path.upmc.edu/cases/case89/micro.html Cryptococcosis (upmc.edu)]. | |||
*[http://path.upmc.edu/cases/case396.html Cryptococcosis - case 2 (upmc.edu)]. | |||
==Cryptosporidiosis== | ==Cryptosporidiosis== | ||
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**Bluish staining of brush border '''key feature''' - low power. | **Bluish staining of brush border '''key feature''' - low power. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Cryptosporidiosis_-_very_high_mag.jpg | Cryptosporidiosis - very high mag. (WC) | |||
Image:Cryptosporidiosis_-_very_high_mag_-_cropped.jpg | Cryptosporidosis - very high mag. - cropped (WC) | |||
</gallery> | |||
www: | |||
*[http://www.tulane.edu/~wiser/protozoology/notes/images/cp_path.gif Schematic picture of cryptosporidium & bowel (tulane.edu)]. | |||
*[http://www.brown.edu/Courses/Digital_Path/systemic_path/GI/cryptosporidiosis.html Micrograph of cryptosporidiosis (brown.edu)]. | |||
Notes: | Notes: | ||
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*Yeast forms. | *Yeast forms. | ||
*Locations: oral cavity, vagina. | *Locations: oral cavity, vagina. | ||
===Gross=== | |||
Esophageal candidiasis: | |||
*"Sticky": do not wash-off from the mucosa with water irrigation.<ref>URL: [https://www.ncbi.nlm.nih.gov/books/NBK537268/ https://www.ncbi.nlm.nih.gov/books/NBK537268/]. Accessed on: 2022 June 22.</ref> | |||
===Microscopic=== | ===Microscopic=== | ||
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*''Dimorphic'' - seen in two forms: | *''Dimorphic'' - seen in two forms: | ||
**Pseudohyphae<ref name=Ref_WMSP3>{{Ref WMSP|3}}</ref> - collections of many ''C. albicans'' cells in a branching pattern. | **Pseudohyphae<ref name=Ref_WMSP3>{{Ref WMSP|3}}</ref> - collections of many ''C. albicans'' cells in a branching pattern. | ||
**Yeast form - single cells, 10 to 12 micrometres in diameter | **Yeast form - single cells, 10 to 12 micrometres in diameter.{{fact}} | ||
Notes: | Notes: | ||
*May be described as "sticks and stones". | *May be described as "sticks and stones". | ||
====Images==== | |||
www: | |||
*[http://pathmicro.med.sc.edu/mycology/candi4.jpg Candida (pseudohyphae) - methenamine silver (med.sc.edu)]. | |||
<gallery> | |||
Image:Candida_pap_1.jpg | Candida on Pap test. (WC) | |||
File:Candidiasis (5494228352).jpg | Candidiasis. (WC/Yale Rosen) | |||
File:Candidiasis - PAS (5493634827).jpg | Candidiasis: PAS stain. (WC/Yale Rosen) | |||
File:Candidiasis - GMS (5493634393).jpg | Candidiasis: Pseudohyphae + Budding yeast. (WC/Yale Rosen) | |||
</gallery> | |||
===Stains=== | ===Stains=== | ||
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*PAS +ve. | *PAS +ve. | ||
*Methenamine silver +ve. | *Methenamine silver +ve. | ||
*[[Gram stain|Gram]] +ve.<ref name=pmid20711156>{{Cite journal | last1 = Salerno | first1 = C. | last2 = Pascale | first2 = M. | last3 = Contaldo | first3 = M. | last4 = Esposito | first4 = V. | last5 = Busciolano | first5 = M. | last6 = Milillo | first6 = L. | last7 = Guida | first7 = A. | last8 = Petruzzi | first8 = M. | last9 = Serpico | first9 = R. | title = Candida-associated denture stomatitis. | journal = Med Oral Patol Oral Cir Bucal | volume = 16 | issue = 2 | pages = e139-43 | month = Mar | year = 2011 | doi = | PMID = 20711156 }}</ref> | |||
==Blastomycosis== | ==Blastomycosis== | ||
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*[[Aspergillosis]]. | *[[Aspergillosis]]. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Zygomycosis.jpg | Zygomycosis - [[cytology]]. (WC) | |||
</gallery> | |||
www: | |||
*[http://granuloma.homestead.com/ZygoHE_02.jpg Mucormycosis (homestead.com)]. | *[http://granuloma.homestead.com/ZygoHE_02.jpg Mucormycosis (homestead.com)]. | ||
*[http://path.upmc.edu/cases/case181.html Mucormycosis - several images (upmc.edu)]. | *[http://path.upmc.edu/cases/case181.html Mucormycosis - several images (upmc.edu)]. | ||
==Aspergillosis== | ==Aspergillosis== | ||
{{Main|Aspergillosis}} | |||
==Microsporidiosis== | ==Microsporidiosis== |
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