Coccidioidomycosis osteomyelitis masquerading as a bone tumor: A report of 2 cases

Nancy P. Caraway, Christina V. Fanning, John M. Stewart, Jeffery J. Tarrand, Kristy L. Weber

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Coccidioidomycosis involving the lung is common in endemic areas. However, it is unusual for it to present as a solitary bone lesion. CASES: Two cases of Coccidioides immitis osteomyelitis clinically and radiographically mimicked a primary bone tumor. Fine needle aspiration (FNA) biopsy of these lytic bone lesions yielded diagnostic material. Aspirated material in 1 case showed a suppurative, granulomatous inflammation and scattered spherules with refractile walls, some containing endospores consistent with coccidioidomycosis. Smears in the other case showed acute inflammation and necrosis, and rare spherules were identified with the Gomori-mathenamine-silver stain. C immitis infection was confirmed by culture in both cases. CONCLUSION: Although rare, coccidioidomycosis can involve the bone and mimic a primary bone tumor. FNA biopsy is helpful in differentiating between inflammatory and neoplastic processes involving bone by acquiring material for cytologic studies and cultures.

Original languageEnglish (US)
Pages (from-to)777-782
Number of pages6
JournalActa cytologica
Issue number5
StatePublished - Jan 1 2003


  • Aspiration biopsy
  • Bone neoplasms
  • Coccidioido-mycosis
  • Osteomyelitis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology


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