PMC3090634_01
Endoscopic view from the lower part of the bronchus intermedius. The mucosa appears inflamed and slightly nodular at the level of the middle lobe bronchus, on the anteromedial wall. On the middle lobe carina, there is a discreet polypoid lesion. RML: right middle lobe bronchus. RLL: right lower lobe bronchus.
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fig1
Interestingly, a discreet mucosal polypoid lesion was observed on the middle lobe carina (Figure 1).
(a) Bronchial biopsy showing epithelial hyperplasia and few Leishmania amastigotes within subepithelial histiocytes (white arrowhead). (Hematoxylin-Eosin x200). (b) A higher magnification view of the positive area. Several collections of Leishmania amastigotes are indicated by black arrowheads (Giemsa x1000).
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fig2
Bronchial biopsies taken from this lesion revealed epithelial hyperplasia and several Leishmania amastigotes within histiocytes (Figures 2(a) and 2(b)).
Transbronchial needle biopsy of a mediastinal lymph node showing histiocytes containing abundant Leishmania amastigotes (H-E x 1000). Insert shows a close-up view of an amastigote. Its ovoid shape, eccentric nucleus, and kinetoplast are discerned.
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fig3
Transbronchial needle biopsies (TBNB) targeted at the right lower paratracheal lymph node also revealed histiocytes containing abundant Leishmania amastigotes (Figure 3).