PMC9368318_01
(A) Placenta showing edema and a large area of ecchymotic hemorrhage (arrow) on the allantoic surface. (B) Fetal lung showing congestion and multiple yellow-white tubercle nodules scattered throughout its surface (arrow). (C) Enlarged and congested fetal liver showing multiple yellow-white tubercle nodules (black arrow). Also, note multiple tubercle nodules adhered to the inner surface of the thoracic cavity (white arrow).
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F1
The expelled placenta was thickened, edematous, and multifocal to coalescing ecchymotic hemorrhages on the allantoic surface (Figure 1A). The striking finding in the fetus was the presence of multiple, white-yellow, solid nodules scattered over the lung, the pleura, and the liver which measured from 2 to 15 mm in diameter (Figure 1B). The liver was found enlarged considerably, congested, and had multiple tubercle nodules (Figure 1C). The DNA extracted from the lung and the liver showed amplification of the IS6110 region of MTBC by PCR (Supplementary Figure 1).
(A) HE-stained lung section showing granuloma with mineralization and caseous necrosis (arrow) surrounded by scattered lymphocyte and macrophage infiltration, and concentric layers of fibrosis. HE x 100. (B) HE-stained liver section showing dark blue areas of mineralization (arrow) and macrophage and fibrous tissue infiltration. HE x 200.
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F2
On histology, the lung and liver sections showed typical granulomatous lesions characterized by a central area of caseous necrosis and mineralization surrounded by scattered lymphocytes, macrophages, and/or occasional giant cells, and concentric layers of fibrosis (Figures 2A,B, 3A).
(A) HE-stained lung section showing scattered macrophages (black arrow), few lymphocytes, and a multinucleate giant cell (filled arrow). HE x 400. (B) ZN-stained section of liver showing sparse acid-fast bacilli (arrow). ZN x 1,000.
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F3
On histology, the lung and liver sections showed typical granulomatous lesions characterized by a central area of caseous necrosis and mineralization surrounded by scattered lymphocytes, macrophages, and/or occasional giant cells, and concentric layers of fibrosis (Figures 2A,B, 3A). Scarce acid-fast bacilli were observed on ZN-stained sections of the lung and the liver (Figure 3B).