Botryoid clusters in a hepatic cystic lesion: a clue to botryomycosis?
Botryomycosis is a rare chronic bacterial infection characterized by suppuration and granulomatous inflammation. Although its name misleadingly suggests a fungal etiology (from the Greek myces, “fungus”), botryomycosis is a bacterial infection caused by non-filamentous organisms, most commonly Staphylococcus aureus or Pseudomonas spp., that form characteristic pseudomycotic granules. While approximately 75% of cases affect the skin, visceral involvement occurs in about 25% of cases, with hepatic localization being exceptionally uncommon. A 50-year-old man presented with hepatomegaly and multiple hepatic cysts. Initial clinical suspicion included neoplasia and parasitic infection. Fine-needle aspiration (FNA) of the hepatic lesions revealed basophilic, rounded bacterial aggregates (“botryoid clusters”), with focal areas demonstrating a Splendore-Hoeppli reaction, indicative of botryomycosis. FNA cytology enabled a definitive, minimally invasive diagnosis of hepatic botryomycosis, an exceptionally rare condition, thereby preventing misdiagnosis as neoplasia or other granulomatous diseases.
Authors
- Camila Cordeiro Barbosa (ORCID: https://orcid.org/0000-0001-7837-4246)
- Paulo Henrique Condeixa de França (ORCID: https://orcid.org/0000-0002-1750-9132)
- Karina Munhoz de Paula Alves Coelho (ORCID: https://orcid.org/0000-0002-4743-8742)
- Hercílio Fronza (ORCID: https://orcid.org/0000-0002-0353-0926)
- Jaqueline Stall (ORCID: https://orcid.org/0000-0003-1181-8003)
- Francis Rossetti Pedack (ORCID: https://orcid.org/0009-0007-9382-5042)
- Raquel Francine Liermann Garcia (ORCID: https://orcid.org/0009-0005-2600-6640)
- José Guilherme Jasper Pickler (ORCID: https://orcid.org/0009-0003-9291-8109)
- Juliana Lins Maués
- Suzana Bastos Batista
- Bruna Louise Silva
Institutions
- Universidade do Estado de Santa Catarina (BR)
- Universidade da Região de Joinville (BR)
- Pathological Society (GB)
- Hospital Municipal São José (BR)
- National Institute of Science and Technology (ID)
Publication Details
- Journal
- Surgical and Experimental Pathology
- Published
- 2026-01-23
- DOI
- https://doi.org/10.1186/s42047-026-00221-y
- Primary Topic
- Actinomycetales infections and treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Ministério da Ciência, Tecnologia e Inovação
- Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina