Fine-needle aspiration of subcutaneous phaeohyphomycosis caused by Wangiella dermatitidis.

Two cases of subcutaneous phaeohyphomycosis, first recognized by fine-needle aspiration (FNA), were confirmed with culture, excision, and histologic study. Both patients had debilitating medical problems and a solitary mass on the left leg. Pigmented hyphae and other fungal elements, numerous in both aspirates, assumed a variety of forms that did not permit specific identification. Culture grew Wangiella dermatitidis in both cases. FNA also yielded purulent exudate, multinucleated giant cells, and, in one case, epithelioid histiocytes. Both excised lesions were abscesses, with associated granulomatous inflammation, fibrosis, and plant splinters. Fungi in sections resembled those seen in the aspirates.