目的提高病理医师对组织胞浆菌病(Hp)和球孢子菌病(Cd)的认识,提高及时诊断的概率。方法回顾1例Hp和1例Cd的诊治过程,并复习文献。结果 Hp和Cd常首先表现为肺部单发或多发结节性病灶,很似结核,附近淋巴结常被波及,临床有发热、咳嗽、咳痰及血象偏高等。经真菌培养和活检可确诊。结论 Hp和Cd由于少见而易误诊,甚至发生全身性播散而导致病情加重。诊断的关键是考虑到此病,尤其是对发热、咳嗽、咳痰、抗炎治疗无效者。病理要密切联系临床,并以高倍镜和油镜仔细观察,PAS等染色常可发现典型的病原体。 Objective To improve the pathologists’ understanding of histoplasmosis (Hp) and coccidioidomycosis (CD) and improve the probability of timely diagnosis. Methods One case of Hp and one case of Cd were reviewed and reviewed. Results Hp and Cd often first manifested as single or multiple pulmonary nodular lesions, similar to tuberculosis, lymph nodes are often affected near the clinical fever, cough, sputum and hyperpigia. After fungal culture and biopsy can be diagnosed. Conclusion Hp and Cd are exacerbated by rare and easily misdiagnosed and even systemic dissemination. The key is to consider the diagnosis of the disease, especially for fever, cough, sputum, anti-inflammatory treatment ineffective. Pathology should be closely linked to clinical and high magnification and oil mirror careful observation, PAS and other staining can often find a typical pathogen.