13690              CRYPTOCOCCOSIS (TORULOSIS)

A woman aged 67 was admitted complaining of headache for 6 weeks with fever, a dry cough, malaise, anorexia and night sweats.  On examination there was a temperature of 100o but no other significant findings.  The CSF showed 24 polymorphs and 58 lymphocytes/c.mm and Cryptococcus neoformans was identified by smear and culture.  The complement fixation test for torula was positive 1 in 5 on admission, but on two subsequent occasions the test was negative.  Chest X-ray showed a small rounded opacity in the lingular segment of the left lung.  It was solid on tomography.  She was treated intensively with Amphotericin B and the fever and meningeal symptoms rapidly improved.  After two months the lingular segment of the left lung containing the lesion was resected.

The specimen is of this resected portion of lung cut to display a solid grey mass 2 cms in diameter with a slightly mucinous appearance in places.  Dilated bronchi surround it.  Histology showed typical cryptococcal cells.