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Presented by Jonathan Epstein, M.D. and prepared by Angelique W. Levi, M.D.
Case 1: 42 year old male with a lung nodule.
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Question 1 of 1
1. Question
Week 4: Case 1
A 42 year old male with a lung nodule.
Correct
Answer: Cryptococcosis
Histology: There is a localized nodule in the lung which has a myxoid appearance at low power. At higher magnification, there are numerous rounded structures which have a gray translucent appearance. These structures are situated within empty spaces and occasionally identified within histiocytes. There is no significant foreign body giant cell reaction. Although these features are diagnostic in and of themselves for cryptococcosis, special stains for mucicarmine will highlight the mucoid capsule.
Discussion: Exogenous lipid pneumonia consists of large irregular droplets of fat surrounded by multinucleated giant cells. Signet right cell carcinomas consist of vacuolated cells with eccentric crescentic shaped nuclei. Endogenous lipid pneumonia is characterized by foamy macrophages accumulating within alveoli.
Incorrect
Answer: Cryptococcosis
Histology: There is a localized nodule in the lung which has a myxoid appearance at low power. At higher magnification, there are numerous rounded structures which have a gray translucent appearance. These structures are situated within empty spaces and occasionally identified within histiocytes. There is no significant foreign body giant cell reaction. Although these features are diagnostic in and of themselves for cryptococcosis, special stains for mucicarmine will highlight the mucoid capsule.
Discussion: Exogenous lipid pneumonia consists of large irregular droplets of fat surrounded by multinucleated giant cells. Signet right cell carcinomas consist of vacuolated cells with eccentric crescentic shaped nuclei. Endogenous lipid pneumonia is characterized by foamy macrophages accumulating within alveoli.
