case_images: PMC6683832_01
case_images: Lateral cervical area of patient with swollen and draining lymph nodes.
case_images: CRIM2019-7838596.001.jpg
case_images: PMC6683832_01_CRIM2019-7838596.001.jpg
case_images: fig1
case_images: On examination, the patient, a tall and thin man, (BMI = 19.6 Kg/m2), with normal skin color, had a normal physical appearance except for his left lateral neck lesion including draining tract sinuses with purulent material (Figure 1) and scarce low-pitched expiratory wheezes.
case_images: Chest CT image showing small (3 mm) nodules (black arrow) in the apical-posterior segment of the left upper lobe.
case_images: CRIM2019-7838596.002.jpg
case_images: PMC6683832_01_CRIM2019-7838596.002.jpg
case_images: fig2
case_images: The computed tomography (CT scan) showed minimal fibrous bands in the upper zone area of the right upper lobe, while a small calcified nodule (3 mm diameter) was also found in the periphery of the apical-posterior segment of the left upper lobe (Figure 2).
case_images: Small area with anthracotic discoloration (black arrow) in the posterior segment of the right upper lobe.
case_images: CRIM2019-7838596.003.jpg
case_images: PMC6683832_01_CRIM2019-7838596.003.jpg
case_images: fig3
case_images: Fiberoptic bronchoscopy revealed a diffusely red and hyperemic bronchial mucosa, particularly intense in the segments of the right upper lobe, with the presence of some small anthracotic areas (Figure 3).
case_images: (a) Tuberculous granuloma with collections of epithelioid macrophages (thin two-direction black arrow) and Langhans giant cells (simple thick black arrow) H-EX400. (b) Central coagulative necrosis (thin two-direction black arrow) with a rim of epithelioid cells ("lightning" black arrow) H-EX100.
case_images: CRIM2019-7838596.004.jpg
case_images: PMC6683832_01_CRIM2019-7838596.004.jpg
case_images: fig4
case_images: Final diagnosis for TL was established by histopathologic examination (Figures 4(a) and 4(b)).