III.
Blastomycocis
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Case 23:
Blastomycocis / Myelogenic leukaemia
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Blastomycocis
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Myelogenic leukaemia
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![Click here to see the picture 23-A1](figuras/23-0001p.jpg) Fig.23-A1 Blastomycosis
A patient from Louisville /Kentucky, USA shows in his face and on his neck several subcutaneous nodules with crusts on the surface. The patient looks healthy. The x-ray examination of his thorax reveals in the upper fields of both lungs numerous infiltrates. After the histological diagnosis a therapy with Ketokonazol was successful.
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![Click here to see the picture 23-B1](figuras/23-0004p.jpg) Fig.23-B1 Myelogenic leukaemia
On the forehead of the patient some smaller and one major tumor formation can be seen.
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![Click here to see the picture 23-A2](figuras/23-0002p.jpg) Fig.23-A2 Blastomycosis
The tissue reaction in the HE stain and higher magnification consists in a non-specific granulation tissue with some giant cells. Furthermore, numerous relatively large yeast-like cells are visible laying partly within giant cells and presenting the aspect of double membranes.
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![Click here to see the picture 23-B2](figuras/23-0005p.jpg) Fig.23-B2 Myelogenic leukaemia
The histology of the bone marrow shows mainly immature white blood cells. Pappenheim stain; 1000 x.
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![Click here to see the picture 23-A3](figuras/23-0003p.jpg) Fig.23-A3 Blastomycosis
With the higher power and in the HE stain large cells of Blastomyces dermatitidis are seen, with solitary budding where the smaller daughter cell is sitting broad on the mother cell. Again the "shrinking aspect" of the membrane can be recognized.
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