Author(s)

Howard D. Epstein¹, Cory D. Sessum², Christian Freudiger², Steven Pastore², Javier A. Longoria³

¹Pathology Department, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA.
²Invenio Imaging Inc, Santa Clara, CA, USA.
³Department of Pulmonary Medicine, Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA.

Background: Cryptococcus neoformans is an opportunistic fungal pathogen that primarily affects immunocompromised individuals. While traditional histologic methods such as hematoxylin and eosin (H&E) staining can sometimes identify fungal organisms, definitive diagnosis typically requires microbiological culture or molecular testing. Stimulated Raman Histology (SRH) is an emerging imaging technology that enables rapid, label-free tissue analysis, potentially improving intraoperative diagnostic workflows. Aim: This case report explores the utility of SRH for the real-time identification of pulmonary cryptococcosis, highlighting its potential to enhance tissue triage and expedite diagnosis. Case Presentation: We report a 44-year-old man with a history of smoking and alcohol use who presented with a right lower lung mass. An ION robotic-assisted bronchoscopy was performed, and SRH was used intraoperatively for real-time tissue evaluation. Within approximately 90 seconds, SRH provided morphologic findings indicative of Cryptococcus neoformans, prompting additional microbiological testing, which confirmed the diagnosis. The patient required a six-week hospitalization with antifungal therapy. Conclusion: This case demonstrates the potential of SRH as a rapid, intraoperative diagnostic tool for detecting fungal infections in pulmonary specimens. By enabling real-time morphological assessment, SRH can optimize biopsy specimen triage, reduce the need for repeat procedures, and improve patient management. Integrating SRH into diagnostic workflows may be particularly beneficial in resource-limited settings, where timely cryptococcosis diagnosis is critical.

Rapid OnSite Assessment (ROSE), FNA, Cryptococcus, Fungal Infection Diagnosis, SRH, Histology

Epstein, H. , Sessum, C. , Freudiger, C. , Pastore, S. and Longoria, J. (2025) Rapid Identification of Cryptococcus Organisms Easily Possible with Stimulated Raman Histology on a Pulmonary Tiny Biopsy Specimen: A Case Report. Case Reports in Clinical Medicine, 14, 80-85. doi: 10.4236/crcm.2025.142010.