PMC10497360_01
(a) Chest X-ray showing diffuse bilateral reticulonodular changes. (b) Chest CT scan showing diffuse bilateral reticulonodular opacities with multiple left lung calcifications and cardiomegaly with dilated pulmonary trunk.
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Chest X-ray showed diffuse bilateral reticulonodular infiltrates without bilateral hilar lymphadenopathy (Figure 1(a)) with differentials of pulmonary tuberculosis with fibrosis, sarcoidosis, and pneumoconiosis. Other significant findings included cardiomegaly and a dilated pulmonary trunk (Figure 1(b)).
(a, b) H&E x100 shows effacement of lung tissue by multiple variably sized naked noncaseating granulomata (red arrows) with surrounding fibrosis containing lymphocytic cells. (c-d) H&E x400 shows a high-power view of noncaseating granulomata (orange star) with multinucleate Langhans giant cells (black arrow).
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Hematoxylin and eosin-stained slides showed effacement of lung architecture by multiple naked noncaseating granulomata, a few associated with Langhans' giant cells (Figures 2(a)-2(d)) The features were suggestive of a noncaseating granulomatous inflammation with differentials of sarcoidosis, foreign body inhalation, and parasitic infection.