Interesting Case of the Month - (IGHP, ICOM) - June
june 2024
Clinical History-
34-year-old malepresented with history of chronic diahorrhea with infiltrative liver disease. UGIE-Reduced duodenal folds and antral region hyperemia
Microscopic Images-
Histology showing areas of villous blunting by moderate expansion of superficial lamina propria by dense aggregates of foamy histiocytes along with lympho-plasmacytic inflammation.
Special Stains-
PAS stain - Faint staining noted within the histiocytes.
ZN Stain multiple AFB noted within the histiocytes.
GMS Stain - The bacilli in histiocytes are weakly silver positive
Diagnosis-
Whipple’s Disease
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Crystal storing histiocytosis
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Mycobacterium Avium Intracellulare
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Mycobacterium avium-intracellulare complex consists of 2 species of acid-fast mycobacteria: Mycobacterium avium and Mycobacterium intracellulare. Collectively, they are referred to as MACs.Patients with AIDS with low CD4 counts may develop disseminated disease after inhalation or ingestion. Typically, the organism spreads through the mucosal surfaces and infects the macrophages in the submucosa, with subsequent spread to the lymph nodes, leading to disseminated involvement, which can affect the liver, spleen, and bone marrow.
Cryptosporidiosis
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