PMC9900046_01
Irregularly shaped ulcer on (A) ventral surface of the tongue as well as the floor of the mouth and (B) right lateral border of the tongue
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FIG1
Intraoral examination revealed an irregularly shaped ulcer on the right lateral border of the tongue extending on the ventral surface of the tongue as well as the floor of the mouth measuring approximately 5 x 4 cm in size (Figure 1).
Photomicrograph of the specimen shows (A) numerous yeast cells in vacuolated cytoplasm of macrophage (arrows) (hematoxylin & eosin (HE), 40x). (B) High-power photomicrograph of the specimen showing macrophages with intracellular microorganisms surrounded by a clear halo (arrows) (HE, 100x, oil immersion)
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FIG2
Few granulomas were noted between the skeletal muscle fibers and nerves (Figure 2).
Numerous circular yeast-like cells stained black (arrow) scattered throughout the tissue. (A) Grocott methenamine silver (GMS) (40x). (B) GMS (100x, oil immersion)
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FIG3
Grocott methenamine silver (GMS) and periodic acid-Schiff (PAS) staining showed numerous intracytoplasmic fungal organisms throughout the lesional tissue (Figures 3, 4).
Numerous magenta-colored circular yeast-like cells (arrow) scattered throughout the tissue in clusters and individually. (A) Periodic acid-Schiff (PAS) (40x). (B) PAS (100x, oil immersion)
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FIG4
Grocott methenamine silver (GMS) and periodic acid-Schiff (PAS) staining showed numerous intracytoplasmic fungal organisms throughout the lesional tissue (Figures 3, 4).
Resolution of ulcer over (A) base of the tongue and (B) right lateral border of the tongue after one month of antifungal therapy
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FIG5
After one month of follow-up, there was a marked resolution of lesions with significant symptomatic improvement (Figure 5).