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60 year old man with ulcerated lesions of the right eyelid
Digital Journal of Ophthalmology 1996
Volume 2, Number 8
November 27, 1996
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J Oscar Croxatto, MD | Fundacion Oftalmologica Argentina Jorge Malbran
Ricardo Negroni, MD | Hospital Municipal F. J. Muiz
Gabriela Volpe, MD | Hospital Oftalmologico Santa Luca
Ancillary Testing
Radiographic Studies


Pathology
A biopsy of the right eyelid showed an ulcerated skin lesion with pseudoepitheliomatous epidermal hyperplasia. The tissue was infiltrated by a mixture of suppurative and granulomatous inflammation with multinucleated giant cells containing round structures. Grocott stain revealed the presence of intracellular and extracellular budding round yeasts, some of them with a ship's-wheel configuration consistent with Paracoccidioides brasiliensis.
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Figure 2
A chest radiograph showed multiple bilateral nodular lesions of the lung with collapse of the inferior right lobe. Computed tomography revealed a cavitated lesion with an air-fluid level.

Figure 3
Figures 3-4. Epithelial hyperplasia with epithelioid and multinucleated giant cells containing round structures (PAS, X125). Groccott stain disclosing multiple budding yeast (X250)

Figure 4