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Acta Cytologica A Report of Two Cases with Differential Diagnosis and Diagnostic Pitfalls Seema S. Mullick, M.D., Dina R. Mody, M.D., and Mary R. Schwartz, M.D. BACKGROUND: Gastrointestinal (GI) histoplasmosis management and therapy. Careful attention to the nu- is a rare manifestation of Histoplasma capsulatum clear and cytoplasmic details of histiocytes and histio- (HC) infection. There are no reports of its cytologic diag- cytelike cells is important to avoid interpretive errors. nosis in the literature. Diagnostic pitfalls include signet ring cell adenocarcino- CASES: A search of the cytology and surgical pathology ma, lymphoma, melanoma, goblet cell carcinoid, malako- files of the Methodist Hospital uncovered two cases of GI plakia and such infections as mycobacteria, Entamoeba histoplasmosis and histiocytes within cytologic speci- histolytica and Calymmatobacterium granulomatis. mens. Papanicolaou-stained endoscopic brushings of an Ancillary studies, such as microbiologic cultures and obstructing, apple-core, right colonic mass in a 58-year- immunohistochemical and histochemical staining, can be old, heterosexual male re- performed in the appropriate vealed numerous vacuolated clinical setting. (Acta Cytol single cells interpreted as Careful attention to the nuclear and 1996;40:989–994) suspicious for signet ring cell cytoplasmic details of histiocytes and carcinoma. The resected Keywords: histoplasmo- histiocytelike cells is important to avoid
Acta Cytologica – Karger
Published: Jan 1, 2011
Keywords: histoplasmosis; gastrointestinal diseases
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