PMC9664346_01
MRI brain T2 flair images - inferolateral left temporal lobe lesion with surrounding vasogenic edema (yellow arrow) and 2.7 cm occipital lesion (red arrow).
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Magnetic resonance imaging (MRI) of the brain showed a 2.3 cm mass in the left occipital lobe (Fig. 1).
CT scan of the chest without IV contrast. A: Cavitary pulmonary mass in the superior segment of the right lower lobe measuring approximately 15 x 18 mm (yellow arrow). B: cavitary mass in the posterior left upper lobe measuring 15 x 12 mm (red arrow).
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He underwent a CT chest that showed cavitary masses in the right lower and left upper lobes (Fig. 2).
H&E stain of left necrotic brain tissue at 400X magnification. Upper half of the image shows multinucleated giant cells, golden-brown pigmented, and broad-based hyphae (yellow arrow). The lower half of the image shows blue-purple dusty nuclear debris and pink necrotic areas (red arrow). (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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H&E stained sections revealed brain tissue with areas of pink necrotic tissue surrounded by blue-purple nuclear debris, aggregates of epithelioid histiocytes, multi-nucleated giant cells, acute inflammatory infiltrate, and septate, broad-based hyphae with brown pigment (Fig. 3).
High power (40x) magnification of lactophenol cotton blue stain which show pigmented, septate hyphae (yellow arrows) with long chains of pale brown oval conidia (red arrow) with occasional branching, typical of Cladophialophora bantiana. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
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Mycosel agar. After 4 days at 30 C, a velvety black mold was isolated. Microscopic examination of lactophenol cotton blue stains revealed pigmented, septate hyphae with long chains of pale brown oval conidia with occasional branching, indicating Cladophialophora bantiana (Fig. 4).