PMC3561114_01
a Thoracic CT scan at presentation. Irregular mass impacting the right superior lobar bronchus. b Thoracic CT scan on the eighth day in the ICU. Extensive right pulmonary consolidation.
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F1
A thoracic computed tomography (CT) scan revealed atelectasis caused by an 8 x 7 cm irregular mass impacting the right superior lobar bronchus along with multiple mediastinal and hilar adenopathies (Figure 1a). As radiologic control had also deteriorated (Figure 1b), the decision to commence treatment on the same day with rifampicin, clarithromycin, and ethambutol was taken.
a CMV inclusion. Histological analysis of the lung reveals a very large cell that displays a large violet intranuclear inclusion with a small clear halo (typical owl-eye inclusion; arrow). b CMV immunohistochemistry. Immunohistochemical analysis of the lung reveals anti-CMV positive cells (arrows).
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F2
The pathologist also identified CMV inclusions in the lungs, mediastinal adenopathies, thyroid gland, pancreas, and adrenal glands (Figure 2a). This observation was also confirmed by immunohistochemistry (Figure 2b).