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Bone marrow granulomas secondary to Histoplasmosis sepsis

View larger version (72K): [in this window] [in a new window]   Figure 1. Peripheral smear from an immunocompromised patient presenting with fever. The PMN shown in this view contains multiple organisms (arrow) consistent with a fungal sepsis. Microbiologic studies confirmed these to be Histoplasmosis capsulatum.

View larger version (104K): [in this window] [in a new window]   Figure 2. PMNs with multiple cytoplasmic inclusions containing organisms are noted in this view.

View larger version (161K): [in this window] [in a new window]   Figure 3. Multiple granulomatous lesions of variable size were evident on the patient’s bone marrow biopsy. A typical lesion is shown in this view (arrows). A pale appearing lesion is evident surrounded by normal hematopietic elements.

View larger version (162K): [in this window] [in a new window]   Figure 4. As shown on higher magnification, the lesion consists predominantly of lymphocytes, macrophages, and occasional plasma cells and eosinophils.

View larger version (162K): [in this window] [in a new window]   Figure 5. On higher magnification, groups of organisms (arrows) can be seen throughout the granuloma.

View larger version (169K): [in this window] [in a new window]   Figure 6. The fungal infiltrate (arrow) is also illustrated in this view of another granulomatous lesion.

View larger version (153K): [in this window] [in a new window]   Figure 7. A GMS stain for organisms in one of the granulomatous lesions is shown in this view.

View larger version (144K): [in this window] [in a new window]   Figure 8. The GMS stain shown at higher magnification is shown. Single and groups of organisms within the granuloma are evident.

View larger version (166K): [in this window] [in a new window]   Figure 9. An immunohistochemical stain for CD3 shows the numerous T-cell component of the granulomas.

View larger version (149K): [in this window] [in a new window]   Figure 10. In contrast to the T-cell component of the lesion, only scattered B cells are noted on the CD20 immunohistochemical stain of the granuloma.

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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 Bone marrow response to infectious agents Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Articles Social Bookmarking                   What's this?