Clinicopathologic and Ultrastructural Study of Non-HIV-related Primary Pulmonary Cryptococcosis in China: Report of 43 Cases

Abstract

Objective: To clarify the clinicopathologic and ultrastructural features of primary pulmonary cryptococcosis (PC).

Methods: 43 cases of PC were observed by light microscopy and histochemical staining, including mucicarmine (MC), Alcian blue (AB), periodic acid–Schiff (PAS), and Grocott methenamine–silver (GMS). Transmission electron microscopy (TEM) was performed on 11 fresh and 8 formalin-fixed specimens.

Results: The detective rate of Cryptococcus neoformans (CN) by MC, AB, PAS, GMS staining, and TEM was 61.3% (19/31), 62.2% (23/37), 85.7% (30/35), 79.1% (34/43), and 89.5% (17/19), respectively. All CN detected by TEM had a capsule. Most of them possessed simple structure with undeveloped cellular organelles.

Conclusion: Electron microscopy has a high rate of detecting CN. A combination of histochemical staining and electron microscopy can make an accurate diagnosis of PC.

Keywords::

• Clinicopathology
• Cryptococcosis
• Diagnosis
• Histochemistry
• Pulmonary
• Ultrastructure

ACKNOWLEDGMENTS

The main preliminary research of this study was performed in Shanghai Pulmonary Hospital. Authors thank the collegues in Shanghai Pulmonary Hospital and Tongji Hospital for their helpful work and thank Dr. Yudong Zhang and Jun Gu for their skillful technical assistance.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.