EXFOLIATIVE CYTOLOGY IN THE DIAGNOSIS OF PARACOCCIDIOIDOMYCOSIS: A REPORT OF 2 CASES

Abstract

Paracoccidioidomycosis (PC) is a fungal infection caused by Paracoccidioides brasiliensis. Histopathologic examination is considered the gold standard for the diagnosis. Here we report 2 PC cases. In case I, a 45-year-old white male, rural worker, nonsmoker, nondrinker, presented with an asymptomatic exophytic bilateral ulcer with granulomatous floor on the hard palate extending to the soft palate, palatine tonsil, and posterior wall of the oropharynx. In case II, a 55-year-old white male, smoker, presented with a painful exophytic ulcer with granulomatous floor on the hard palate, bilateral buccal mucosa, tongue, and in labial commissure. In both cases biopsy was performed and histopathologic analysis was inconclusive. Therefore, exfoliative cytology was performed and confirmed the diagnosis of PC by the presence of fungus spores. Exfoliative cytology is not only recommended in clinical suspicion of PC due for easy application, low cost, and fast results, but it is also accurate even when gold standard methods fail. Paracoccidioidomycosis (PC) is a fungal infection caused by Paracoccidioides brasiliensis. Histopathologic examination is considered the gold standard for the diagnosis. Here we report 2 PC cases. In case I, a 45-year-old white male, rural worker, nonsmoker, nondrinker, presented with an asymptomatic exophytic bilateral ulcer with granulomatous floor on the hard palate extending to the soft palate, palatine tonsil, and posterior wall of the oropharynx. In case II, a 55-year-old white male, smoker, presented with a painful exophytic ulcer with granulomatous floor on the hard palate, bilateral buccal mucosa, tongue, and in labial commissure. In both cases biopsy was performed and histopathologic analysis was inconclusive. Therefore, exfoliative cytology was performed and confirmed the diagnosis of PC by the presence of fungus spores. Exfoliative cytology is not only recommended in clinical suspicion of PC due for easy application, low cost, and fast results, but it is also accurate even when gold standard methods fail.