PMC5109572_01
a) A chest X-ray film showing a tumor of approximately 50 mm in size in the right lower field. b) A chest CT scan showing a 48x35 mm tumor with spiculation and notching on the right S9/10. c, d) A gadolinium-enhanced brain MRI scan showing multiple brain tumors with ring enhancement.
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A chest X-ray showed a tumor of approximately 50 mm in size in the right lower field, and a chest computed tomography (CT) scan showed a 48x35 mm tumor with spiculation and notching on the right S9/10 (Fig. 1a and b). A gadolinium-enhanced brain magnetic resonance imaging (MRI) scan showed multiple brain tumors with ring enhancement (Fig. 1c and d).
The transbronchial lung biopsy (TBLB) specimens from the right S9/10 and India ink staining of cerebrospinal fluid. a) Numerous fungal elements are visible as encapsulated yeast with clear halos (Hematoxylin and Eosin staining, TBLB). b) Yeast (Cryptococcus) is visible after staining with periodic acid-Schiff and Grocott methenamine silver stains (TBLB). c) Encapsulated Cryptococci is visible as a halo against a black background (India ink staining, cerebrospinal fluid).
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A histopathological examination of the transbronchial lung biopsy (TBLB) specimen from the right S9/10 revealed numerous fungal elements that appeared as encapsulated yeast with clear halos (Fig. 2a). The yeast was observed after periodic acid-Schiff and Grocott methenamine silver staining (Fig. 2b). India ink staining of the patients' cerebrospinal fluid revealed encapsulated Cryptococci as a halo against a black background (Fig. 2c).