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Splenic caseating granulomas

View larger version (177K): [in this window] [in a new window]   Figure 1. The patient is a 17-year-old female who was being treated for AML. She became febrile, developed LUQ pain and underwent a splenectomy. At low magnification of a splenic section, a normal lymphoid nodule is present. There is extensive hemorrhage surrounding the nodule. Note the thickened capsule.

View larger version (172K): [in this window] [in a new window]   Figure 2. Multiple caseating granulomas are seen in this view with distinct demarcation from the normal splenic parenchyma. A normal appearing lymphoid nodule/germinal center is noted to the left of the granulomas.

View larger version (175K): [in this window] [in a new window]   Figure 3. The granulomatous lesion is demarcated from the surrounding splenic parenchyma. Extensive hemorrhage is also present, circumscribing the lesion.

View larger version (187K): [in this window] [in a new window]   Figure 4. At a higher magnification of the granuloma, the caseating nature of the lesion is more apparent. A cellular infiltrate is present and hyphae can be noted.

View larger version (183K): [in this window] [in a new window]   Figure 5. In another lesion the caseous material is noted to surround a cellular inflammatory response.

View larger version (163K): [in this window] [in a new window]   Figure 6. The nature of the cellular response is more apparent in this higher magnification of the previous image. There are abundant plasma cells and macrophages within the amorphous matrix.

View larger version (177K): [in this window] [in a new window]   Figure 7. A low power view of a GMS stain for fungi shown. The butterfly lesion in the center of the image stains positive for the presence of organisms.

View larger version (183K): [in this window] [in a new window]   Figure 8. At higher magnification, spore-like structures can be seen throughout the lesion.

View larger version (167K): [in this window] [in a new window]   Figure 9. Both spores and hyphae are noted at even higher magnification.

View larger version (169K): [in this window] [in a new window]   Figure 10. Another view of the same lesion is illustrated.

View larger version (158K): [in this window] [in a new window]   Figure 11. The spores and hyphae were felt morphologically to be consistent with trichosporonosis which was confirmed on subsequent fungal cultures.

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This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections Nonlymphoid Lesions of Lymph Nodes and Spleen Related ASH-SAP Chapter Related Image Bank Image Sets Social Bookmarking                   What's this?