Case 80. Coccidioidomycosis of lung (34 y-o F)
         
    Surgical specimen of the apical lung lesion in a Japanese student who traveled in Arizona    
         
   
Key words : Coccidioides immitis, caseous necrosis
   
     
 
     
Encapsulated caseous focus, termed coccidioidoma, closely resembles old tuberculosis (HE, low power).   Cholesterin cleft deposition seen in caseous necrosis. Thick fibrous capsule is formed (HE).
     
 
     
A degenerated sporangium containing endospores is observed in the necrotic background, confirming the diagnosis of coccidioidomycosis (HE, high power).   Endospores in the sporandium of Coccidioides immitis are PAS-positive.