Subcutaneous phaeohyphomycosis: ultrasound findings and histopathologic correlation.
Alessandro Amorim Aita, Carolina Ávila de Almeida, Marcelo Volpatto Ortiz et al.
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Case in brief
A 60-year-old woman presented with a slowly growing subcutaneous nodule. Ultrasound revealed a well-circumscribed hypoechoic pseudocystic lesion with heterogeneous internal echoes and peripheral hypervascularity, leading to a differential diagnosis of an epidermoid cyst or inflammatory collection. Surgical excision and histopathology confirmed subcutaneous phaeohyphomycosis, revealing granulomatous inflammation with pigmented fungal hyphae and a retained thorn.
What made this case unusual
The case highlights the association of subcutaneous phaeohyphomycosis with a retained plant fragment, which is uncommon in fungal infections.
Diagnostic / clinical pearl
Ultrasound can provide valuable insights into the morphology and vascularity of subcutaneous lesions, aiding in the differential diagnosis of rare infections like phaeohyphomycosis.
Why it matters
Increased awareness of the imaging features of subcutaneous phaeohyphomycosis may help radiologists recognize this rare infection earlier, potentially reducing diagnostic delays.