Tag Archives: FRCPath

BLACK FUNGUS WHITE FUNGUS AND YELLOW FUNGUS.

BLACK FUNGUS WHITE FUNGUS AND YELLOW FUNGUS.
What is the black, white and yellow fungus

COVID -19 second wave and journalism in India have introduced us to Black,  white and yellow fungus.  What are these originally?  Let’s decode some terminilogy.

Before delving in let’s look at ways to differentiate two major opportunistic infections in COVID-19 patients based on morphology- MUCOR and ASPERGILLUS.

1. BLACK FUNGUS

What is being referred to as black fungus?

Mucor is being referred to as the black fungus.

Is the fungus itself black in colour?

No,  in a setting of immunosuppression, mucor grows rapidly causing angioinvasion and tissue necrosis.  This results in a blackish appearance of the affected area,  giving rise to the name.

What is the real black fungus?

BLACK FUNGUS WHITE FUNGUS AND YELLOW FUNGUS.
Dermataceous fungi

Some fungii have excess melanin, also called melanized or dermaticious fungi.  They are the real black fungi.  Moreover,  presence of melanin is not uncommon in Histoplasma spp,  Aspergillus spp (especially Aspergillus niger)  and even candida spp.

2. WHITE FUNGUS

What is being referred to as white fungus?

BLACK FUNGUS WHITE FUNGUS AND YELLOW FUNGUS.
White patches in candida

Candida albicans.  This fungus has the tendency to produce patchy white coloured lesions,  hence the name.

3. YELLOW FUNGUS

What is being referred to as yellow fungus?

Mucor septicus.  This fungus has not been associated with any human infections till now.  It’s identification is still a mystery.

What is the real yellow fungus?

BLACK FUNGUS WHITE FUNGUS AND YELLOW FUNGUS.
Aspergillus in culture central blackish pigment and peripheral yellow to white

Aspergillus– When cultured, aspergillus has a blackish center due to the melanin, and whitish or yellowish body.

Actinomycetes has a unique feature, pus in this infection has a yellow color due to the presence of sulfur granules.

That’s it for now! Thank you.

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For Morphologic differences between Mucor and aspergillus check this out!

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6 KEY POINTS FOR BOARDS – MICROPAPILLARY BREAST CARCINOMA

Micropapillary breast carcinoma is a rare variant.

Micropapillary carcinoma of breast has a few unique clinical, microscopic and immunological features which aid in their differentiation from other subtypes of breast carcinoma.

Let’s look at them!!

1. Tufts of cells arranged in pseudopapillae ( lack fibrovascular cores). These pseudopapillae are surrounded by empty clear spaces formed by fibrocollagenous stroma.

Micropapillary breast carcinoma- microscopy

2. Aggressive tumor usually present with angiolymphatic invasion. They present with nodal invasion at the time of presentation.


3. Molecular and cytogenetics: BC-1514 (C21orf118) is commonly upregulated in the micropapillary area.

4. ER positive in 90% and PR positive in 50%

5. Micropapillary breast carcinomas show

‘INSIDE OUT’ staining pattern with EMA and CD15s.

INSIDE OUT staining pattern refers to – staining localized to the apical surface of tumor cells abutting the stroma but absent staining in the basolateral region.

Staining pattern of EMA ( Epithelial membrane antigen) and CD 15s in micropapillary breast carcinoma.

6. Another characteristic of micropapillary breast carcinoma is Incomplete basolateral or CUP SHAPED staining with apical sparing seen with E- cadherin,  Her-2-neu and p-120.

‘Cup shaped’ staining with EMA – stained basolateral surface and apical sparing.

Below is a picture which will help you remember all characteristics of micropapillary breast carcinoma.

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6 KEY POINTS TO REMEMBER IN ACUTE LYMPHOCYTIC LEUKEMIA (ALL) – t(5;14)

6 KEY POINTS TO REMEMBER FOR BOARDS – ACUTE LYMPHOCYTIC LEKUKEMIA- t(5;14)

  1. Basts harbour a translocation between IL3 and an IGH gene, resulting in variable eosinophilia
  2. This diagnosis can be made on the basis of immunophenotypic and genetic findings even if the bone marrow blast count is low.
  3. patients may present with an asymptomatic eosinophilia,
  4. Blasts may be deceptively absent in the peripheral blood.
  5. Eosinophils are a reactive popula­ tion and not part of the leukaemic clone.
  6. The prognosis is not considered to be different from that of other types of ALL

Click below for a summary

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Review question- ALL – RGA

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