Unusual Presentations of Disseminated Cutaneous Rhinosporidiosis Masquerading as Tumour Like Lesions of Skin: A Clinicopathological Study

Abstract

Introduction: Rhinosporidiosis is a chronic granulomatous infective disease caused by Rhinosporidium seeberi which primarily affects the mucosa of the nasal cavity. Cutaneous lesions are infrequent. However, disseminated cutaneous lesions with varied presentations are very rare in routine pathology practice. Aim: The study aimed to diagnose cutaneous lesions due to rhinosporidiosis on Fine-Needle Aspiration Cytology (FNAC) and to confirm the same by histology. Materials and Methods: This was a cross-sectional study. A total of 8 cases of disseminated cutaneous Rhinosporidiosis out of 815 cutaneous lesions were observed over five years, from September 2013 to October 2018, in Department of Pathology, VIMSAR, Burla. FNAC and scrape cytology of the lesions were performed and studied after Diff-Quik and H&E stain. The lesions were excised and histopathological examination was done. Results: It was observed that the overall incidence of cutaneous rhinosporidiosis diagnosed on FNAC was very low (less than 0.1%) They were mainly seen in middle-aged males from low socio-economic status and rural areas. The skin lesions were mostly subcutaneous nodules, few wart-like growth and ulcerative growth, some of which were initially diagnosed as neurofibroma and squamous cell carcinoma. FNAC and histopathological examination helped to confirm the diagnosis of rhinosporidiosis in all cases. Conclusion: Disseminated cutaneous rhinosporidiosis has varied clinical presentations, mimicking other cutaneous lesions. Hence, proper diagnosis of the patient is necessary which can be achieved by FNAC and histopathology.