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CT angiography abdomen, sagittal view: compression of the celiac axis. During deep expiration (A), significant narrowing of the origin of the celiac axis is seen, the worst narrowing is located approximately 6.4 mm from its takeoff. During deep inspiration (B), some improvement of the compression is identified.
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Before admission, he had computed tomography (CT) and CT angiography of his abdomen, revealing significant narrowing of the origin of the celiac axis that worsened with deep expiration (Fig. 1).
Lymph Node with Necrotizing Granuloma. The use of H&E staining at 2x (Panel A) and 20x (Panel B) magnification shows macrophages (arrowhead), an area of necrosis (asterisk), and lymphoid tissue (circle). Small budding yeast (arrowhead) was revealed by GMS staining, 40x magnification (Panel C).
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Hematoxylin and eosin (H&E) staining of the tissue revealed lymph nodes with numerous necrotizing granulomas (Fig. 2A, B). Within the granulomas, Gomori's methenamine silver (GMS) stain revealed small budding yeast, which is particularly suggestive of histoplasmosis (Fig. 2C).