Subsequently, CSF and blood cultures confirmed cryptococcosis. Based on positive cryptococcal antigen detection and India ink tests of the CSF specimen prior to the initial cytologic diagnosis, the presence of C. When an additional slide was stained with the Gomori methenamine silver method, they stained black ( Fig. However, when viewed carefully, the structures contained a brownish dot-like internal structure that was suspected as being a nucleus, with occasional tear drop-shaped budding ( Fig. The initial impression was a contaminant, such as glove powder, because the structures were numerous while the background was almost acellular ( Fig. They stained pale blue and ranged in size from 4 to 11 μm. Microscopic examination revealed many round to oval structures with thick halos ( Fig. It was processed onto a ThinPrep slide and stained with the Papanicolaou stain. The CSF specimen submitted for cytologic examination was clear and colorless. Therefore, CSF examination by lumbar puncture was performed to rule out infectious meningitis. Laboratory tests revealed leukocytosis (white blood cell count, 11.01 × 10 3/μL) and increased C-reactive protein levels (207.3 mg/L) in peripheral blood. After completing 1 cycle of chemotherapy, she presented with a spiking fever (up to 38.3℃) and mental confusion. Excisional biopsy of the cervical mass revealed diffuse large Bcell lymphoma, and she received chemotherapy treatment. On physical examination, a palpable mass was discovered in the right neck, and abdominopelvic computed tomography showed generalized lymphadenopathy. Her past medical history was unremarkable. Liquid-based cytology allows for a clean background and additional slides for ancillary testing, facilitating the detection of microorganisms in CSF specimens, particularly when the number of organisms is small.Ī 73-year-old woman visited the hospital with complaints of myalgia, night sweats, and anorexia for 1 week. Cryptococcosis was confirmed in blood and CSF through the cryptococcal antigen test and culture. Gomori methenamine silver staining was positive. Occasional asymmetrical, narrow-based budding but no true hyphae or pseudohyphae were observed. A cytology slide that was prepared using the ThinPrep method showed numerous spherical yeast-form organisms with diameters of 4–11 μm and thick capsules. To rule out infectious conditions, CSF examination was performed. A 73-year-old woman with diffuse large B-cell lymphoma presented with mental confusion and a spiking fever. Although its cytomorphologic features in conventional smear cytology have been well described, those in liquid-based cytology have rarely been. For additional information visit Linking to and Using Content from MedlinePlus.Cryptococcus neoformans is the most common microorganism found in cerebrospinal fluid (CSF) cytology and causes life-threatening infections in immunocompromised hosts. Any duplication or distribution of the information contained herein is strictly prohibited without authorization. Links to other sites are provided for information only - they do not constitute endorsements of those other sites.

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Cryptococcal meningitis csf findings