Presentation
Aplastic anemia. 6 months post allograft BMT. Cough and fever.
Patient Data
Consolidation in the medial basal left lower lobe with peribronchial thickening. Anterior right apical 3mm granuloma is unchanged. Bilateral lower lobe peribronchial thickening with scattered mucus plugging, greater in the left lower lobe. Tracheobronchial tree patent.
Multiple small hilar mediastinal nodes are likely reactive in etiology.
Soft tissue thickening centered on the right fifth costal cartilage.
Upper abdominal viscera appear unremarkable for non-contrast CT examination.
IMPRESSION
- Left lower lobe consolidation
- Right fifth costal cartilage soft tissue lesion of unknown significance, suggest US-guided biopsy
Case Discussion
US-guided biopsy performed of the right fifth rib soft tissue lesion.
HISTOLOGY REPORT
MICROSCOPIC
Right chest wall biopsy: The sections show collagenous fibrous tissue largely replaced by granulation tissue reaction. Fibroblastic reaction and blood vessel proliferation appear prominent. The inflammatory cell infiltrate is comprised of histiocytes, neutrophils and eosinophils. Additionally, prominent phagocytosis of neutrophils by histiocytes seen. Phagocytosis of red cells not seen. Immunoblastic cells or plasma cells not apparent. No other significant pathological features noted and there is no evidence for malignancy. Immunohistochemistry and special stains for microbial organisms are pending.
SUMMARY
Right chest wall biopsy: Granulation tissue reaction pattern with features of possible haemophagocytosis. Special stains pending.
SUPPLEMENTARY REPORT
Gram stain, Grocott methenamine silver and Wade-Fite stains do not show any microorganisms (bacteria, fungal elements and acid-fast organisms). Immunohistochemistry shows the myofibroblastic nature of the stromal cells in the vascular background consistent with relation tissue reaction. CD20 CD 138 and CD30 stain do not show evidence for an B-cell atypical lymphoid infiltrate. EBER is negative.
Unable to process the form. Check for errors and try again.