PMC5088313_01
(a)-(d) Wright Giemsa stained bone marrow aspirate smear with increased number of histiocytes depicting hemophagocytosis (engulfed white and red blood cell precursors).
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fig1
Aspirate smears showed numerous macrophages with evidence of hemophagocytosis (Figures 1(a)-1(d)).
(a) Bone marrow biopsy with increased number of histiocytes, focally present in loose aggregates, hematoxylin and eosin stain, 40x. (b) CD163 staining on bone marrow biopsy highlighting histiocytes. (c)-(d) GMS (Gomori-Methenamine Silver) staining on bone marrow biopsy. Numerous budding fungal organisms with morphology consistent with Histoplasma are present.
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fig2
Well defined granulomas or areas of necrosis were not seen (Figures 2(a) and 2(b)).