Trucut needle biopsy used to diagnose rectal Basidiobolus infection mimicking neoplasm in children
September 06 2018
Fungal infections can be difficult to diagnose because they can mimic other conditions. Al-Helal and colleagues at Abha Maternity and Children’s Hospital (Saudi Arabia) recently described four cases of suspected rectal neoplasm that were in fact fungal lesions.
The children presented with non-specific symptoms including fever, weight loss, constipation and bleeding from the rectum. Blood tests showed leucocytosis with raised acute phase reactants (ESR, platelets, CRP). Radiological examination showed a lesion involving all four layers of the rectum that narrowed the lumen, but colonoscopy was inconclusive.
In each case a Trucut needle biopsy was diagnostic, with histopathology revealing broad septate hyphae surrounded by eosinophilic material (Splendore-Hoeppli phenomenon), indicating Basidiobolus ranarum. Treatment with itraconazole/voriconazole was successful.
- Visit mediwikis.com for more information about performing Trucut needle biopsies
- Read about basidiobolomycosis mimicking inflammatory bowel disease in Egyptian children
Figure from Ageel et al (2017) showing Splendore-Hoeppli phenomenon of GI basidiobolomycosis biopsy stained with PAS.