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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 62-63

Cytology of disseminated cutaneous rhinosporidiosis


1 Department of Pathology, Burdwan Medical College, Burdwan 713 104, West Bengal, India
2 Department of Pathology, Malda Medical College & Hospital, Malda 732 101, West Bengal, India

Date of Submission03-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Nirmalya Chakrabarti
Department of Pathology, Malda Medical College & Hospital, Malda 732 101, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1944_19

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How to cite this article:
Bandyopadhyay A, Chakrabarti N. Cytology of disseminated cutaneous rhinosporidiosis. Indian J Med Res 2020;152, Suppl S1:62-3

How to cite this URL:
Bandyopadhyay A, Chakrabarti N. Cytology of disseminated cutaneous rhinosporidiosis. Indian J Med Res [serial online] 2020 [cited 2021 Jul 30];152, Suppl S1:62-3. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/62/316743

Patient's consent obtained to publish clinical information and images.


A 50 yr old male farmer presented to the Surgery outpatient department, Burdwan Medical College, Burdwan, West Bengal, India, with soft, non-tender, swellings over multiple sites on the body [Figure 1]A and [Figure 1]B in February 2019, imparting a clinical diagnosis of soft tissue tumour. Fine-needle aspiration cytology showed plenty of endospores and sporangia of different sizes as intact [Figure 2]A and [Figure 2]B and ruptured [Figure 3]. Multiple punch biopsies showed thin epidermis and the presence of sporangia of different sizes in the dermis surrounded by histiocytes and lymphocytes and transepidermal elimination of the sporangium [Figure 4]A, [Figure 4]B, [Figure 4]C. The sporangia and endospores were periodic acid-schiff (PAS) positive confirming diagnosis of disseminated cutaneous rhinosporidiosis. The patient was operated for nasal rhinosporidiosis. After one week of dapsone therapy, the patient developed jaundice, haemolytic anaemia and skin rash. Dapsone was immediately discontinued following development of respiratory distress. Computed tomography thorax revealed multiple lung nodules with pleural effusion. Thoracentesis and treatment with cycloserine and ketoconazole failed to relieve symptoms even after two weeks following which the patient died.
Figure 1: (A) Patient with multiple swellings over the body.

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Figure 2: (A) Cytology smear showing several endospores and growing sporangia of different sizes (Giemsa stain, ×40). (B) Mature sporangia (H and E stain, ×40).

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Figure 3: Cytology smear showing ruptured mature sporangia liberating endospores (Giemsa stain, ×40).

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Figure 4: (A) Punch biopsy of the facial lesion showing thinned out epidermis, growing sporangia in the deep dermis and within subcutaneous tissue, surrounded by dense lympho-histiocytic infiltrate (PAS stain, ×4). (B) A mature sporangia with a pore, through which endospores were seen to extrude in the mucoid matrix. (C) Transepidermal elimination of sporangia (PAS stain, 40).

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Conflicts of Interest: None.


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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