PMC3687172_01
(a) Intraoral examination shows ulcerated and necrotic lesions, (b) Intraoral examination shows coating of the tongue, (c) Extraoral examination shows multiple nodular lesions on the chin, right side of the face and upper lip with an erythematous surface, (d) Multiple plaques like areas on the ventral surface of the forearm, (e) Multiple plaques like areas on the dorsal aspect of thigh
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F1
Oral examination revealed ulcerated and necrotic lesions located on the labial mucosa, lateral borders of tongue, hard and soft palate [Figures 1a and b]. Extraoral examination revealed multiple nodular lesions on the chin, right side of the face and upper lip with an erythematous surface [Figure 1c]. Multiple plaques were seen on the ventral surface of the forearm and dorsal aspect of thigh [Figures 1d and e].
(a) Histopathology shows presence of epithelioid cell granulomas in the connective tissue with numerous histiocytes and multinucleated giant cells. The cytoplasm of the histiocytes shows the presence of small round to oval basophilic bodies surrounded by a clear halo (H and E, x40), (b) Small round to oval basophilic bodies surrounded by a clear halo is seen in the cytoplasm of histiocytes (H and E, x100), (c) High power view of the same field (H and E, x400)
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F2
The cytoplasm of the histiocytes showed the presence of small round to oval basophilic bodies surrounded by a clear halo, which is the characteristic feature of histoplasma capsulatum [Figures 2a-c].
(a) Round to oval basophilic bodies surrounded by a clear halo in the histiocytes (Gomori's methanimine silver, x100), (b) High power view of the same field (GMS, x400)
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F3
These organisms stained highly positive with Gomori's Methanimine Silver stain [Figures 3a and b].