Mucormycosis: Cytomorphological spectrum in fine-needle aspiration cytology
Background: Mucormycosis is a fungal infection that can affect multiple organs. The role of fine-needle aspiration cytology (FNAC) in its diagnosis is not well documented. Aim: The objective of this study was to describe the detailed cytomorphologic features of mucormycosis on FNAC samples. Material...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-01-01
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| Series: | Journal of Cytology |
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| Online Access: | http://www.jcytol.org/article.asp?issn=0970-9371;year=2024;volume=41;issue=1;spage=47;epage=52;aulast=Shastri |
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| author | Malvika Shastri Radhika Srinivasan Reetu Kundu Pranab Dey Nalini Gupta Parikshaa Gupta Manish Rohilla Mandeep Kang Naveen Kalra Harsimran Kaur Shivaprakash M Rudramurthy |
| author_facet | Malvika Shastri Radhika Srinivasan Reetu Kundu Pranab Dey Nalini Gupta Parikshaa Gupta Manish Rohilla Mandeep Kang Naveen Kalra Harsimran Kaur Shivaprakash M Rudramurthy |
| author_sort | Malvika Shastri |
| collection | DOAJ |
| description | Background: Mucormycosis is a fungal infection that can affect multiple organs. The role of fine-needle aspiration cytology (FNAC) in its diagnosis is not well documented. Aim: The objective of this study was to describe the detailed cytomorphologic features of mucormycosis on FNAC samples. Materials and Methods: A retrospective analysis of all cases diagnosed as mucormycosis on FNAC between January 2014 and July 2021 was performed for detailed cytomorphological evaluation and correlation to clinical data and microbiological studies wherever available. FNA was computed tomography-guided (n = 38), ultrasonography-guided (n = 31) or palpation-guided (n = 12), and slides were reviewed in two cases. Results: A total of 83 cases of mucormycosis were evaluated. An immunocompromised setting was observed in 48 cases. The most common site of FNA was the lung (n = 57) followed by liver, soft tissue, palate, mediastinum, orbital/ocular region, and lymph node. Isolated renal involvement, a unique feature, was seen in seven cases. The aspirates were necrotic to pus-like or blood-mixed particulate. Broad, nonseptate, foldable, ribbon-like fungal hyphae showing right-angled branching were seen. The tissue reaction was predominantly necro-inflammatory (n = 36), bland necrotic (n = 22), mixed inflammatory (n = 16), suppurative (n = 5), necrotizing granulomatous (n = 3), and granulomatous (n = 1). Immunocompromised patients showed mixed inflammatory responses more frequently. Fungal culture was positive for Rhizopus species in 2/13 cases and molecular testing in two additional cases corresponding to Rhizopus and Syncephalastrum spp. Conclusion: FNA provides quick and conclusive diagnosis of mucormycosis from varied anatomic sites enabling prompt institution of therapy. The tissue response is variable and to some extent dependent on the immune status of the patient. |
| first_indexed | 2024-04-24T16:05:05Z |
| format | Article |
| id | doaj.art-4b82888e15464535ad95e8d0beb777a3 |
| institution | Directory Open Access Journal |
| issn | 0970-9371 |
| language | English |
| last_indexed | 2024-04-24T16:05:05Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Cytology |
| spelling | doaj.art-4b82888e15464535ad95e8d0beb777a32024-04-01T05:55:42ZengWolters Kluwer Medknow PublicationsJournal of Cytology0970-93712024-01-01411475210.4103/joc.joc_107_23Mucormycosis: Cytomorphological spectrum in fine-needle aspiration cytologyMalvika ShastriRadhika SrinivasanReetu KunduPranab DeyNalini GuptaParikshaa GuptaManish RohillaMandeep KangNaveen KalraHarsimran KaurShivaprakash M RudramurthyBackground: Mucormycosis is a fungal infection that can affect multiple organs. The role of fine-needle aspiration cytology (FNAC) in its diagnosis is not well documented. Aim: The objective of this study was to describe the detailed cytomorphologic features of mucormycosis on FNAC samples. Materials and Methods: A retrospective analysis of all cases diagnosed as mucormycosis on FNAC between January 2014 and July 2021 was performed for detailed cytomorphological evaluation and correlation to clinical data and microbiological studies wherever available. FNA was computed tomography-guided (n = 38), ultrasonography-guided (n = 31) or palpation-guided (n = 12), and slides were reviewed in two cases. Results: A total of 83 cases of mucormycosis were evaluated. An immunocompromised setting was observed in 48 cases. The most common site of FNA was the lung (n = 57) followed by liver, soft tissue, palate, mediastinum, orbital/ocular region, and lymph node. Isolated renal involvement, a unique feature, was seen in seven cases. The aspirates were necrotic to pus-like or blood-mixed particulate. Broad, nonseptate, foldable, ribbon-like fungal hyphae showing right-angled branching were seen. The tissue reaction was predominantly necro-inflammatory (n = 36), bland necrotic (n = 22), mixed inflammatory (n = 16), suppurative (n = 5), necrotizing granulomatous (n = 3), and granulomatous (n = 1). Immunocompromised patients showed mixed inflammatory responses more frequently. Fungal culture was positive for Rhizopus species in 2/13 cases and molecular testing in two additional cases corresponding to Rhizopus and Syncephalastrum spp. Conclusion: FNA provides quick and conclusive diagnosis of mucormycosis from varied anatomic sites enabling prompt institution of therapy. The tissue response is variable and to some extent dependent on the immune status of the patient.http://www.jcytol.org/article.asp?issn=0970-9371;year=2024;volume=41;issue=1;spage=47;epage=52;aulast=Shastricytomorphologyfine-needle aspiration cytologyhyphaemucormycosis |
| spellingShingle | Malvika Shastri Radhika Srinivasan Reetu Kundu Pranab Dey Nalini Gupta Parikshaa Gupta Manish Rohilla Mandeep Kang Naveen Kalra Harsimran Kaur Shivaprakash M Rudramurthy Mucormycosis: Cytomorphological spectrum in fine-needle aspiration cytology Journal of Cytology cytomorphology fine-needle aspiration cytology hyphae mucormycosis |
| title | Mucormycosis: Cytomorphological spectrum in fine-needle aspiration cytology |
| title_full | Mucormycosis: Cytomorphological spectrum in fine-needle aspiration cytology |
| title_fullStr | Mucormycosis: Cytomorphological spectrum in fine-needle aspiration cytology |
| title_full_unstemmed | Mucormycosis: Cytomorphological spectrum in fine-needle aspiration cytology |
| title_short | Mucormycosis: Cytomorphological spectrum in fine-needle aspiration cytology |
| title_sort | mucormycosis cytomorphological spectrum in fine needle aspiration cytology |
| topic | cytomorphology fine-needle aspiration cytology hyphae mucormycosis |
| url | http://www.jcytol.org/article.asp?issn=0970-9371;year=2024;volume=41;issue=1;spage=47;epage=52;aulast=Shastri |
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