case_images: PMC2779309_01
case_images: Abdominal computed tomography (CT) scan shows the multiple conglomerated soft tissue density lesions noted at the mesenteric root, aortocaval space and left paraaortic space; the CT scan also shows the smooth luminal narrowing noted at the third portion of the duodenum, resulting in marked dilatation of the stomach and proximal duodenum (A). Eight weeks later, the follow up abdominal CT scan shows that there is a marked decrease in the sizes and extents of multiple conglomerated lymphadenopathies in the mesenteric root, aortocaval and left paraaortic space, and the previous noted obstruction of the duodenal third portion is resolved (B).
case_images: jkms-20-1059-g001.jpg
case_images: PMC2779309_01_jkms-20-1059-g001.jpg
case_images: F1
case_images: Abdominal computed tomography (CT) scan showed multiple conglomerated soft tissue density lesions noted in the mesenteric root, aortocaval space and left paraaortic space and smooth luminal narrowing was noted at the third portion of the duodenum: this resulted in the marked dilatation of the stomach and proximal duodenum (Fig. 1A). It showed marked decrease in the sizes and extents of the multiple conglomerated lymphadenopathies in the mesentery, and resolution of the previous noted obstruction of the duodenal third portion (Fig. 1B).
case_images: Under sonographic guidance, percutaneous needle biopsy was performed on the mesenteric conglomerated lymph nodes, and it shows chronic granulomatous inflammation with focal necrosis and a fungal organism: this is consistent with the cryptococcal infection noted on silver staining (A, x400) and hematoxylin and eosin staining (B, x100).
case_images: jkms-20-1059-g002.jpg
case_images: PMC2779309_01_jkms-20-1059-g002.jpg
case_images: F2
case_images: Histopathologic finding showed chronic granulomatous inflammation with focal necrosis and the presence of fungal organisms, which were consistent with cryptococci (Fig. 2).