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| Year : 2014 | Volume
: 31
| Issue : 3 | Page : 181-182 |
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| Aspergillus involving submandibular salivary gland: An unusual presentation |
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Ruchita Tyagi, Pranab Dey
Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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| Date of Web Publication | 29-Nov-2014 |
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How to cite this article:
Tyagi R, Dey P. Aspergillus involving submandibular salivary gland: An unusual presentation. J Cytol 2014;31:181-2 |
Sir,
Aspergillus is seen worldwide as community or hospital acquired infection. Aspergillus are known to cause infections in human beings, [1] out of which about 80% of infections are caused by Aspergillus fumigatus. Aspergillus flavus is commonly involved in sinusitis. [2] The lung is commonly infected by this fungus. Aspergillus has also been demonstrated in extrapulmonary sites such as orbit, molar region, canthus of the eye and maxillary area. [3] Hereby, we are describing an unusual case of Aspergillus involving the right submandibular gland.
A 45-years-old man complained of a firm, painless swelling in the submandibular region for past 3 months. He was empirically started on anti-tuberculous therapy, but the swelling remained as such. The submandibular swelling was subsequently subjected to fine needle aspiration cytology (FNAC). The swelling was very firm and yielded only scanty material on FNAC. The smears showed numerous epithelioid cell granulomas with scattered multinucleated giant cells in a dirty necrotic background. Many scattered Aspergillus fungi were seen. The fungi showed thin septated structure with acute angle branching as negative profiles. Many flat sheets of benign salivary ductal epithelial cells were also noted. Periodic acid Schiff stain showed better demonstration of the fungal hyphae with acute angle branching consistent with the morphology of Aspergillus [Figure 1] and [Figure 2]. Ziehl Neelsen stain for acid-fast bacilli was negative. | Figure 1: Aspergillus in the multinuclated giant cell (Periodic acid Schiff , ×440)
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 | Figure 2: Higher magnification showing acute angle branching in Aspergillus (Periodic acid Schiff , ×1200)
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Aspergillus shows dichotomously acute angle branched septated hyphae of uniform thickness (five to ten microns). [3] Fungal culture is required to confirm the species of Aspergillus. In this case, as the fungal infection was not suspected clinically, hence fungal culture was not sent. The diagnosis on FNAC was helpful in further management of the patient as the patient responded to antimycotic treatment.
 References | |  |
| 1. | Pfaller MA, Diekema DJ. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol 2010;36:1-53.  |
| 2. | Nicolle MC, Benet T, Vanhems P. Aspergillosis: Nosocomial or community-acquired? Med Mycol 2011;9:S24-9. |
| 3. | Das R, Dey P, Chakrabarti A, Ray P. Fine-needle aspiration biopsy in fungal infections. Diagn Cytopathol 1997;16:31-4. |
Correspondence Address:
Pranab Dey
Department of Cytology and Gynecologic Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh - 160 012
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-9371.145671
[Figure 1], [Figure 2] |
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