PMC4531545_01
Chest X-ray on second hospital day, shows rapidly aggravated bilateral airspace consolidation.
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A repeat chest radiograph showed nearly complete opacification of both lung fields (Figure 1).
Skin biopsy showing numerous encapsulated yeast-like organisms surrounded by large clear spaces and inflammatory cells consisting of lymphoid cells in subcutis (H&E stain, x400).
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Skin biopsy showed granulomatous inflammation in the dermis and numerous yeast organisms with clear thick capsules (Figure 2).
Chest CT showed a irregular, spiculated nodule with cavity at the apicoposterior segment of the left upper lobe.
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After 10 days of fluconazole therapy, his chest radiograph and CT scan showed marked clearing with only one cavitary nodular lesion on the left upper lobe (Figure 3).
High power microscopic finding of fine needle aspiration specimen of the pulmonary nodule shows scattered round to ovoid cryptococcus with polysaccharide capsules and occasional budding with inflammatory cells consisting of histiocytes and a few giant cells (PAS stain, x400).
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Cytologic examination of the aspirates also revealed a typical morphology of the numerous cryptococci (Figure 4).