Tissue changes in cryptococcosis: histologic alteration from gelatinous to suppurative granulomatous tissue response with asteroid body.

The histologic variety and transformation in cutaneous cryptococcosis with acute lymphocytic leukemia before antifungal treatment and after the start of treatment were studied by the light and electron microscopic examinations. The initial cutaneous lesions before treatment revealed gelatinous tissue reactions, and Cryptococcus neoformans (serotype A) were isolated from the skin biopsy specimen and blood. However, later recurrent cutaneous lesions receiving antifungal treatment revealed suppurative granulomatous tissue reactions, and fungal cultures of the skin biopsy specimen changed to negative even though numerous yeasts stained with PAS were observed in skin lesions. Moreover, in the later lesion a few giant cells contained asteroid bodies without central spores. Ultrastructure of the later cutaneous lesions is presented.