PMC8591547_01
A. Direct laryngoscopy revealed a yellowish inflamed lesion at the right false vocal cord B. Chest radiography revealed multifocal thick wall cavitary lesions and air-fluid level C. Chest CT at the upper trachea showed multiple irregular thick wall cavities D. Chest CT at the lower lung zone revealed multifocal cavitary lesions that connect to the bronchus and mimic cystic-bronchiectasis, multifocal consolidation, and ground-glass opacity and large pleural based cavities with air-fluid level at the posterior segment of the left lower lung.
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Chest radiography revealed thick irregular multifocal wall cavitary lesions with focal air-fluid level (Fig. 1).
Biopsy of the larynx and lungs A. Histopathologic findings of tissue from the larynx revealed multinucleated giant cells (yellow circles), which contained intracellular organisms B. GMS staining of tissue from the larynx showed organisms 2-4 mum in diameter with internal septation C. PAS staining of tissue from the larynx showed numerous intracellular organisms D. H&E staining of lung tissue revealed histocytes with numerous intracellular organisms E. GMS staining of the lung tissue was positive for yeasts. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Histopathologic examination of the false vocal cord revealed granulomatous inflammation with several small lymphocytes and few neutrophil infiltration, as well as aggregation of histiocytes containing round intracytoplasmic organisms (Fig. 2).