Fig.29-A1
Blastomycosis

A 36-years old businessman in the State of Ohio, USA had to travel frequently in this region and the neighboring States. He noted an ulcerated skin tumor covered by crusts at the upper parts of his nose which had grown in several weeks and was surrounded by smaller skin tumors. Another tumor with an intact surface developed in the corner of his left eye. Clinically metastases of a lung tumor were assumed.

Fig.29-A2
Blastomycosis

The histology of his skin tumor on the nose shows a thickening of the epidermis and a granulation tissue with several giant cells. Some large yeast-like cells were laying partly in histiocytes. They could be fungal cells of B. dermatitidis. The marked tropism of the skin is typical in this mycosis. HE stain.

Fig.29-A3
Blastomycosis

The Grocott method confirms the presence of fungal cells with single budding. Here we should remember that the patient had traveled mostly in an endemic region of blastomycosis.