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Presented by Jonathan Epstein, M.D. and prepared by Justin Poling, M.D.
Case 2: A 79 year old male presented with a prostate nodule and underwent a needle biopsy.
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1. Question
Week 542: Case 2
A 79 year old male presented with a prostate nodule and underwent a needle biopsy.images/poling/12312012/case2_10x.jpg
images/poling/12312012/case2_20x.jpg
images/poling/12312012/case2_FM.jpg
images/poling/12312012/case2_GMS.jpgCorrect
Answer: Cryptococcosis
Histology: Scattered within the prostate core are several granulomas with central microabscess formation. Multinucleated giant cells are noted within several of the granulomas. Within several of the histiocytes are cytoplasmic vacuoles in which small translucent rounded structures can be visualized. These structures were positive for Fontana Masson, GMS, and mucicarmine (not shown). In addition, there were several small glands suspicious for adenocarcinoma of the prostate (not shown).
Discussion: Fungal infections of the prostate usually occur in immunocompromised hosts with disseminated mycoses. Blastomycosis, coccidiomycosis, and cryptococcosis are the most common diseases. Cases have also been reported of histoplasmosis, paracoccidiomycosis, aspergillosis, and candidiasis of the prostate. The histology in these cases is identical to that seen in nonprostatic sites.
Incorrect
Answer: Cryptococcosis
Histology: Scattered within the prostate core are several granulomas with central microabscess formation. Multinucleated giant cells are noted within several of the granulomas. Within several of the histiocytes are cytoplasmic vacuoles in which small translucent rounded structures can be visualized. These structures were positive for Fontana Masson, GMS, and mucicarmine (not shown). In addition, there were several small glands suspicious for adenocarcinoma of the prostate (not shown).
Discussion: Fungal infections of the prostate usually occur in immunocompromised hosts with disseminated mycoses. Blastomycosis, coccidiomycosis, and cryptococcosis are the most common diseases. Cases have also been reported of histoplasmosis, paracoccidiomycosis, aspergillosis, and candidiasis of the prostate. The histology in these cases is identical to that seen in nonprostatic sites.
