Anatomic Pathology: Pulmonary Pathology

86) Which is TRUE regarding the process in this image?

• Zygomycosis is a rapidly invasive, necrotizing infection, often with angioinvasion. It is associated with acidosis, and is seen in diabetic patients with bouts of diabetic ketoacidosis.

• Although it is not a common pulmonary infection, when present it is usually acute and angioinvasive and is not the cause of a chronic mass lesion. The structures, because of their branching and empty appearance, can be mistaken for blood vessels, especially on hematoxylin-eosin stain; however, they are not vascular channels and, therefore, are not part of an endothelial neoplasm.

• The structures are fungi, not the vasculature of a myxoid liposarcoma. Some fragmented structures in cases of zygomycosis can resemble foreign material or vegetable matter; however, the regular branching structures are characteristic of fungal hyphae.

Frater JL, Hall GS, Procop GW: Histologic features of zygomycosis. Emphasis on perineural invasion and fungal morphology. Arch Pathol Lab Med 2001;125:375-378.

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