PMC9418189_01
Endoscopic imaging from the sigmoid colon showing non-bleeding severely ulcerated mucosa that were present throughout the entire left side of the colon.
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The patient underwent a flexible sigmoidoscopy (Fig. 1) which revealed non-bleeding severely ulcerated mucosa.
(A), (B): Hematoxylin-eosin stain of the patient's colon biopsy, showing foamy histiocytes filling the lamina propria. Round, 2-5 microm intracellular organisms are identified, compatible with yeast forms of Histoplasma spp. (A) 400x, (B) 1000x. (C), (D): Grocott's Methenamine Silver stain highlights abundant 2-5 microm yeast with narrow-base budding, consistent with Histoplasma spp. (C) 400x, (D) 1000x.
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Histoplasma spp (Fig. 2). Histological examination of a bone marrow biopsy demonstrated leukophagocytosis and erythrophagocytosis with extensive marrow involvement by fungal organisms consistent with Histoplasma spp. (Fig. 3).
Representative high magnification images of the bone marrow aspirate (Wright-Giemsa stain, 1000x) show histiocytes which have numerous engulfed yeast forms and additionally demonstrate hemophagocytosis, both leukophagocytosis (A) and erythrophagocytosis (B).
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Histoplasma spp (Fig. 2). Histological examination of a bone marrow biopsy demonstrated leukophagocytosis and erythrophagocytosis with extensive marrow involvement by fungal organisms consistent with Histoplasma spp. (Fig. 3).