30-year-old man.
Enolic habit of 100 g/day.
Moderate smoker.
tonsillectomy and hysterectomy in childhood
In adolescence, there were two episodes of pneumonia, one in LID and another in LSD.
Studyed by contact with a tuberculous relative.
Complementary tests: blood count: hematocrit 38.5%, Hb 12.3 g/dl, leukocytes 9,300 thousands/mm3 with normal formula and count, ESR 27 mm in the first hour.
Serum chemistry: urate 7.3 mg/dl, cholesterol 261 mg/dl, HDL 33 mg/dl, AST 55 IU/L, ALT 84 IU/3.6 IU/L, TG 88 microglobulin 53 IU/L, serum ferritin
Chest X-ray: right paratracheal adenopathies, bilateral hiliar and possibly subcarinal.
Cholecystic abdominal CAT scan: numerous thoracic and abdominal lymph nodes; mild stenosis.
Histopathological study: a biopsy of an inguinal adenopathy was performed. The architecture was completely replaced by numerous proliferative, non-necrotizing granulomatous formations consisting of epithelioid macrophages and multinucleated giant cells.
In the multinucleated giant cells an acicular birefringent material was found after observation with polarized light.
The investigation of acid-resistant bacilli through the technique of auramine, with control, on two different blocks of ganglionic tissue, yielded negative results.
1.
A comparative study of polarization and contrast phases was performed on the images obtained from tissue sections and a quartz pattern and an arena commonly used.
The analysis showed in the tissue, smaller crystalline foreign bodies of 5 %, and aglomerated foreign bodies of 40-50 %, consistent with quartz.
Due to the histological characteristics and mineral deposit we consider as the first etiological cause the labor activity in construction.
