PMC7283144_01
Nodular swelling at the dorsum of the right foot overlying the first and second metatarsal bones. There are skin discoloration and desquamation from the underlying enlarging lesion.. MRI images demonstrated multi-lobulated soft tissue lesion overlying the distal part of the first metatarsal bone eroding its base suggestive of mycetoma.
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A 49-year Indian male with no significant past medical history or chronic diseases presented to Hamad General Hospital, Doha, Qatar with a three years history of non-painful nodular swelling at the dorsum of the right foot (Figure 1). Magnetic Resonance Imaging of the right foot (Figure 1) demonstrated a suspicious lesion with irregular multi-lobulated soft tissue mass overlying the distal first metatarsal bone accompanied with surrounding bony erosions.
Numerous brown pigmented fungal organisms amidst a zone of marked acute inflammation (H& E X 200).. Rounded heavily pigmented thick-walled fungal cells (H&E X 400); C and D - Giemsa stain (X 200) and PAS stain (X 400) highlight the fungal cells.
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Fungal and bacterial cultures of the obtained tissues failed to grow any pathogen while histopathological examination revealed necrotizing granulomatous inflammation, surrounded by numerous brown pigmented fungal organisms, arranged in the form of solid clusters of thick-walled fungal cells, displaying features compatible with chromoblastomycosis (Figure 2).
PMC7283144_02