*2.7.1.2 Cryptococcosis (European blastomycosis)*

*Cryptococcus neoformans* is ubiquitous; it is found in soil and pigeon excrements. The fungal cell is of 4–7 μm in size, replicates by budding, and is stained with H&E, mucicarmin, and PAS. Cryptococci cause a spectrum of various changes in the lungs. A typical granulomatous reaction presents with confluent non-necrotizing granulomas, many multinucleated giant cells, and a mild inflammatory reaction; giant cells are located mainly outside the granulomas and contain cryptococcal cells (**Figure 11**).

These fungi can also be located inside necrotizing granulomas (cryptococcomas) resembling those with mycobacterial and other types of fungal infections (**Figure 12**). In immunocompromised individuals, cryptococcal cells are found inside the alveoli, in their walls, and in the interstitium, without marked inflammatory reaction; some scattered multinucleated giant cells can be found [9].
