How Can Pathologists Contribute to Diagnosing Rare Fungal Infections?

Histopathological examination is a key method for confirming fungal infections, which are often challenging to diagnose using culture and serological tests alone. Additionally, identifying the causative fungal species through histopathology provides guidance for selecting antifungal agents and treatment strategies. However, as histopathological diagnosis relies primarily on fungal morphology, distinguishing species can be difficult when rare fungi share similar features. Molecular techniques, such as polymerase chain reaction and sequencing, increasingly applied to formalin-fixed paraffin-embedded tissue, have become valuable tools for diagnosing rare fungal infections. The most effective approach combines detailed fungal morphological assessment with molecular testing. However, molecular test results must be interpreted in the context of the histopathological findings from the examined material. Notably, enhanced diagnostic accuracy through histopathology and molecular techniques enables more precise antifungal treatment, improving patient outcomes. This review highlights the importance of histopathological examination in diagnosing rare invasive fungal infections and underscores the pathologist's essential role in identifying them.