A 28-year-old AIDS patient (CD4 count 45 cells/µL) presents with headache, confusion, and fever. CSF India ink preparation shows budding encapsulated yeast. Cryptococcus neoformans CNS infection in immunocompromised hosts typically produces which histopathological pattern?

• A Suppurative meningitis with dense neutrophilic exudate
• B Multinucleated giant cell granulomas with caseation
• C Perivascular cuffing with lymphocytes and microglial nodules
• D Gelatinous pseudocysts (soap bubble lesions) in the basal ganglia with minimal inflammatory response ✓

Explanation

In severely immunocompromised patients, Cryptococcus neoformans replicates extensively in perivascular Virchow-Robin spaces in the basal ganglia, forming 'soap bubble' or gelatinous pseudocysts filled with mucoid capsular material and minimal inflammatory infiltrate due to immunosuppression. In immunocompetent hosts, a granulomatous reaction may form. The prominent polysaccharide capsule is the key virulence factor.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.