Qap (Anatomical Pathology) 

QAP Peer Review

AP120
Case History: F/36, renal transplant patient; history of sinusitis; right nasal septal nodule.
Intended diagnosis: Fungal infection (Alternaria species). Contributed by:IOLN
Code Diagnosis Comment Score
anonymous Nasal cavity - Suppurative granuloma, fungal infection suggestive of Cryptococcus (100%) Suggest fungal stain, Mucicarmine stain and fungal culture.  100
anonymous Granulomatous inflammation(Fungal infection),100% Suggestive of cryptococcal infection 1. Suggest confirmation with special stains, including mucicarmine and Grocott. 2. Correlation with microbiological study.  100
anonymous Supurative granulomatous inflammation with yeast-like organisms ?Cryptococcus. 100% Mucicarmine and Grocott stains will be helpful. Correlate with microbiology culture results.  100
anonymous NASAL SEPTAL NODULE : SUPPURATIVE GRANULOMATOUS INFLAMMATION (100%). Some organisms are suspected to be present. One of the possibilities is cryptococcosis. Special stains including Grocott and periodic acid-Schiff are necessary. Other organisms should also be excluded with a panel of special stains, e.g. Ziehl-Neelsen stain, etc. The result should also be correlated with cultural results.  100
anonymous Suppurative granulomatous inflammation due to fungal infection, highly suggestive of cryptococcus Mucicarmine/Grocott stain and culture to confirm diagnosis  100
anonymous CRYPTOCOCCOSIS. 100% nil  100
anonymous Suppurative granulomatous inflammation with presence of fungal spores suggestive of cryptococcus. (100%) Do PAS or Grocott stains to confirm fungal spores and perform mucicarmine stain to highlight the capsule of cryptococcus spores. Also suggest fungal culture.  100
anonymous Nasal septal nodule - Fungal infection, probably cryptococcosis 100% To do fungal stain (Grocott/PAS) and mucicarmine stain to highlight the capsules for confirmation  100
anonymous Suppurative granulomatous inflammation, favour cryptococcal infection >95% Suggest mucicarmine, Grocott, Ziehl-Neelsen stain. Also send tissue for culture if available.  100
anonymous Granulomatous inflammation consistent with cryptococcal infection 100% Suggest fungal stain  100
anonymous Fungal infection 100% Grocott staining needs to be performed for confirmation. Fungal culture is also required for accurate identification.  100
anonymous Fungal infection, consistent with Cryptococcosis (100%) nil  100
anonymous Fungal infection,correlate with culture result and perform PASD, MC, Grocott, ZN. Probability : 100% nil  100
anonymous Fungal infection, consistent with cryptococcal infection 100% Granulomatous inflammation is present. Mucicarmine stain to be performed to confirm the presence of cryptococcal organisms. Grocott and acid fast stains to be performed to exclude other fungal or mycobacterial infections.  100
anonymous Cryptococcal infection 100% nil  100