case_images: PMC10367195_01
case_images: Chest tomography with the affected lymph nodes marked.
case_images: 1678-9849-rsbmt-56-e0072-2023-gf1.jpg
case_images: PMC10367195_01_1678-9849-rsbmt-56-e0072-2023-gf1.jpg
case_images: f1
case_images: Chest tomography revealed mediastinal adenomegaly, with some lymph nodes forming 2.9 x 2.5 cm clusters in the aorta and alveolar consolidation in the left upper lung lobe (Figure 1).
case_images: (A) Paraaortic lymph node biopsy, presenting gigantocellular reaction with foci of caseous necrosis associated with a lymphocytic inflammatory infiltrate. Hematoxylin-eosin, 40x magnification. (B) Left upper lobe biopsy of the lung, showing caseous necrosis, adjacent epithelioid histiocytes, organized alveolar pneumonia, alveolar septal/interstitial fibrosis, central acinar emphysema and alveolar exudate macrophages. Hematoxylin-eosin, 40x magnification.
case_images: 1678-9849-rsbmt-56-e0072-2023-gf2.jpg
case_images: PMC10367195_01_1678-9849-rsbmt-56-e0072-2023-gf2.jpg
case_images: f2
case_images: The biopsy of the para-aortic lymph node showed foci of caseous necrosis associated with lymphocytic inflammatory infiltrates (Figure 2A). A left upper lobe lung biopsy showed caseous necrosis, adjacent epithelioid histiocytes, organized alveolar pneumonia, alveolar septal or interstitial fibrosis, centriacinar emphysema, and alveolar exudate macrophages (Figure 2B).
case_images: Graph showing platelet count per microliter at hospital admission and throughout treatment.
case_images: 1678-9849-rsbmt-56-e0072-2023-gf3.jpg
case_images: PMC10367195_01_1678-9849-rsbmt-56-e0072-2023-gf3.jpg
case_images: f3
case_images: By then both corticosteroids and azathioprine had been discontinued (Figure 3).