PMC8349082_01
(A) Hematoxylin and eosin (H&E) stain shows the glomerulus which appears unremarkable under light microscopy. (B) The biopsy with Jones silver stain that is without spikes or pinhole vacuolations detected by light microscopy. (C) Immunofluorescence with global granular capillary loop IgG deposits (3+) (D) An electron microscopy picture of the glomerulus. The blue arrow demonstrates effacement of the foot processes or podocytes. The black arrow exhibits sub-epithelial amorphous deposits. The white arrow depicts a partially resorbed sub-epithelial deposit. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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CT of the chest remarkable for a new right lower lobe consolidation and re-accumulation of right-sided pleural effusion, with a background of emphysema, and peripherally oriented ground-glass opacities with sub-pleural sparing in the lungs, likely related to fibrosis.
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CT scan was notable for a new right lower lobe consolidation and re-accumulation of right-sided pleural effusion (Fig. 2).
(A, B) Lung biopsy with red brown material filling up alveoli airspaces. (C) The blue arrow depicts type 2 pneumocytes, which line the alveoli, with hyperplasia. The yellow arrow demonstrates small red-brown granules of hemosiderin. The black arrow points out larger, denser red-brown macrophages which are phagocytosing the hemosiderin, called hemosiderin-laden macrophages. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Pathology demonstrated benign lung parenchymal tissue with patchy areas of alveolar hemorrhage and an extensive collection of intra-alveolar hemosiderin containing macrophages consistent with pulmonary hemosiderosis (Fig. 3).