PMC10367195_01
Chest tomography with the affected lymph nodes marked.
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Chest tomography revealed mediastinal adenomegaly, with some lymph nodes forming 2.9 x 2.5 cm clusters in the aorta and alveolar consolidation in the left upper lung lobe (Figure 1).
(A) Paraaortic lymph node biopsy, presenting gigantocellular reaction with foci of caseous necrosis associated with a lymphocytic inflammatory infiltrate. Hematoxylin-eosin, 40x magnification. (B) Left upper lobe biopsy of the lung, showing caseous necrosis, adjacent epithelioid histiocytes, organized alveolar pneumonia, alveolar septal/interstitial fibrosis, central acinar emphysema and alveolar exudate macrophages. Hematoxylin-eosin, 40x magnification.
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The biopsy of the para-aortic lymph node showed foci of caseous necrosis associated with lymphocytic inflammatory infiltrates (Figure 2A). A left upper lobe lung biopsy showed caseous necrosis, adjacent epithelioid histiocytes, organized alveolar pneumonia, alveolar septal or interstitial fibrosis, centriacinar emphysema, and alveolar exudate macrophages (Figure 2B).
Graph showing platelet count per microliter at hospital admission and throughout treatment.
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By then both corticosteroids and azathioprine had been discontinued (Figure 3).