Hematoxylin and eosin (H & E)-stained sections demonstrate numerous vacuolated areas (arrows) surrounded by a diffuse, mixed inflammatory infiltrate (A; original magnification x20) and numerous epithelioid histiocytes
with small, circular yeast cells (arrows), characteristic of H capsulatum (B; original magnification x 40).
LEF was stopped 12 Interstitial lymphoid Favorable hyperplasia with with CS MTX giant cells was stopped 13 NA NA NA NA Epithelioid histiocytes
Central NA Favorable Our necrosis, granulomatous with CS and case 1 inflammation, and rituximab.
In the entire thickness of the dermis, granulomas with epithelioid histiocytes
and large multi-nucleated cells containing internal structures similar to fungi were found (figure 1A).
Microscopic examination revealed a fibrocollagenous cyst wall lined by sheets of foamy histiocytes, epithelioid histiocytes
with multinucleated foreign body type of giant cells and chronic inflammatory cells with one area showing vague hyphal forms on hematoxylin and eosin stain.
Skin biopsy revealed dermal granulomas composed of epithelioid histiocytes
. Focal central necrosis was seen with few foamy histiocytes especially around the adnexae.
Histopathological examination of the biopsy samples showed normal epidermis and caseating tuberculoid granulomas containing epithelioid histiocytes
and Langhans giant cells in the papillary dermis (Fig.3).
An ultrasound guided biopsy of liver mass showed chronic lymhoplasmacytic inflammation with caseation necrosis and giant cells surrounded by epithelioid histiocytes
(11) A third retrospective analysis with pooled data from multiple eye centers across the United States reported that all ophthalmic biopsies contained varying degrees of granulomatous inflammation with either giant cells or epithelioid histiocytes
. (6) Many of the GPA specimens had obvious extravascular granulomas, some had inflammation surrounding (but not involving) vessels, and only one case had obvious granulomatous vasculitis.
There are often isolated multinucleated giant cells (figure 1) and occasional epithelioid histiocytes
, but well-formed granulomas are not seen.
Portal tracts revealed mononuclear cell infiltration with formation of vague granulomas of epithelioid histiocytes
and admixed eosinophils.
Both times, pathology demonstrated chronic granulomatous inflammation, collagen interspersed with inflammatory infiltrate, and sheets of epithelioid histiocytes
Histologic examination revealed an intramural lesion composed entirely of spindle and epithelioid histiocytes
arranged in a palisaded pattern, with central necrosis (Figure 1) similar to the features of a rheumatoid nodule.