PMC5892290_01
Lymph node biopsy. H&E stain. Low-power view (a). Paracortical (T-zone) hyperplasia (b). At higher magnification (c, d), this zone contains interdigitating dendritic cells, Langerhans cells, and melanin-containing histiocytes. There are also scattered immunoblasts in the paracortex of unknown significance.
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fig1
He underwent lymph node biopsy which showed no evidence of lymphoma (Figure 1).
The bone marrow shows eosinophilia. Low-power H&E of the core (a), a high-power H&E from the clot section (b), and an oil immersion image from the aspirate (Giemsa stain) (c).
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fig2
Bone marrow biopsy showed eosinophilia that varied from approximately 25% in the aspirate smears to 60% in the core biopsy (Figure 2).
Timeline summarizes the laboratory changes on daily follow-up throughout admission. Rapid decline of eosinophil count from 9,500/mcl to zero levels within less than 24 hours from administration of imatinib is noted. Uric acid level slightly declined and potassium level remained stable except for the last day during which it raised progressively to the level of 7.5 mmol/L.
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fig3
Absolute eosinophil count dropped dramatically from 9,500 cells/mcL to 0 cells/mcL within less than 24 hours following administration of imatinib (Figure 3).
Chest X-ray showed patchy airspace infiltrates in the left lower lobe suggestive of pneumonia.
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fig4
On the next day, chest X-ray showed patchy airspace infiltrates in the left lower lobe suggestive of pneumonia (Figure 4).
CT abdomen and pelvis showed prominent bowel loops with wall thickening, suggestive of bowel ischemia.
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fig5
A CT abdomen and pelvis showed prominent bowel loops with wall thickening, suggestive of bowel ischemia (Figure 5).