Table 1: Comparison of fungal morphological diagnosis with clinical microbiology culture results.

Morphology

Type of granuloma

Specimen

Morphological diagnosis

Culture results

1. Small yeasts with central dot

Necrotizing

Lung

Pneumocystis jiroveci

No growth

2. Small yeasts with narrow-based budding

Necrotizing

Lung

Histoplasma

Histoplasma

3. Septate branching hyphae

Plasmacytic/Eosinophilic

Lung

Aspergillus

Aspergillus niger

4. Small yeasts with narrow-based budding and halos

Non- necrotizing

Lung

Cryptococcus neoformans

Cryptococcus neoformans

5. Small yeasts with narrow-based budding and halos

Non- necrotizing

Lung

Cryptococcus neoformans

Cryptococcus neoformans

6. Spherules

Necrotizing

Lung

Coccidioides spp

No fungal culture performed

7. Yeasts with narrow-based budding

Necrotizing

Lung

Histoplasma capsulatum

No culture performed

8. Hyaline branching

Plasmacytic/Eosinophilic

Lung

Mold, not otherwise specified

Aspergillus fumigatus

9. Variably-sized (3-10 microns) budding yeasts

Non- necrotizing

Lung

Capsule-poor Cryptococcus neoformans

Cryptococcus neoformans

10. Spherules

Necrotizing

Lung

Coccidioides spp

No fungal culture performed

11. Spherules

Eosinophilic

Lymph node

Coccidioides spp

Coccidioides spp

12. Branching fungus

Necrotizing

Lung

Branching fungus

Candida tropicalis

13. Hyaline hyphae

Necrotizing

Lung

Aspergillus spp.

Coccidioides spp

14. Spherules

Necrotizing

Lymph node

Coccidioides spp

Coccidioides spp

15. Septate branching hyphae

Plasmacytic/Eosinophilic

Lung

Aspergillus spp.

Aspergillus niger

16. Spherules

Necrotizing

Lung

Coccidioides spp

No growth

17. Spherules

Necrotizing

Lung

Coccidioides spp

Coccidioides spp

18. Small yeasts with narrow-based budding

Necrotizing

Lung

Histoplasma capsulatum

Histoplasma capsulatum

19. Branching septate hyphae

Necrotizing

Lung

Branching hyphae

No growth

20. Spherules

Necrotizing

Lung

Coccidioides spp

Coccidioides spp

21. Small yeasts with narrow-based budding

Necrotizing

Lung

Histoplasma capsulatum

No growth

22. Spherules

Necrotizing

Lung

Coccidioides spp

Coccidioides spp

23. Small yeasts with narrow-based budding and halos

Necrotizing

Lung

Cryptococcus neoformans

No culture performed

24. Spherules

Necrotizing

Lung

Coccidioides spp

No growth

25. Large yeasts with broad-based budding

Necrotizing

Lung

Blastomyces

Blastomycosis

26. Spherules

Necrotizing

Lung

Coccidioides spp

Coccidioides spp

27. Spherules

Sclerosing

Lung

Coccidioides spp

Coccidioides spp

28. Large yeasts with broad-based budding

Necrotizing

Lung

Blastomyces

Blastomycosis

29. Small yeasts with halos

Non- necrotizing

Lung

Cryptococcus neoformans

Cryptococcus neoformans

30. Spherules

Necrotizing

Lymph node

Coccidioides spp

Coccidioides spp

31. Spherules

Necrotizing

Lung

Coccidioides spp

No growth