The Sheep in Wolf’s Clothing: Vegetable and Fruit Particles Mimicking Cells and Microorganisms in Cytology Specimens

Abstract

Background: Microorganisms and contaminants, including food contaminants, can be difficult to distinguish in various cytologic specimens. Vegetable and fruit contaminants can be found in specimens from the gastrointestinal tract, as in anal Pap smears, or aspirated into the respiratory tract, as in bronchiolar-alveolar lavage. Some of these materials mimic microorganisms, normal human cells, and even malignant cells, making correct diagnosis of the cytology specimen a challenge. A catalogue of the cytologic appearance of these contaminants will increase awareness of these diagnostic stumbling blocks.

Cuerpos vegetales en histopatología

“…La zanahoria (daucus carota), el rábano (raphanus sativus) y la coliflor (brassica oleracea var. botrytis) simulan células escamosas y las células del tomate (Solanum lycopersicum) simulan un adenocarcinoma mucinoso (24,25). Para poder diferenciar una célula maligna de las células vegetales, estas últimas poseen un pared retráctil gruesa hiperrefractiva, son de forma rectangular, se disponen de forma regular espacialmente y el núcleo es amorfo (22,26) (Figura 5).…”

“…Otros alimentos descritos que simulan microorganismos se encuentran el brócoli (brassica oleracea var. italica), aparentando tricomonas vaginalis, frijoles verdes en estructuras que parecen elementos fúngicos del coccidioides y las células del pimentón (Capsicum annuum) se asemejan a toxoplasmosis (24).…”

Plant material (aeriferous parenchyma and sclereid cells) mimicking mucormycosis in sputum cytology

“…In summary, there is limited literature reporting how plant cells can be confused with fungi in cytological smears. [6][7][8] Although the presence of vegetable matter in sputum samples is usually due to oral contamination, aspiration pneumonia cannot be excluded, especially in older patients with poor buccal hygiene, alcoholism, and situations where their swallowing reflex is altered. 9…”