case_images: PMC10160796_01
case_images: (A) Axial fusion image of FDG PET/CT scan showing hypermetabolic adenopathy in the
  mediastinum, hypermetabolic lung nodules, and hypermetabolic bone lesions seen in both
  scapula. (B) Coronal fusion images of FDG PET/CT scan showing hypermetabolic liver
  lesions, hypermetabolic diffuse extensive bone lesions, and hypermetabolic
  lymphadenopathy and lung lesions in the chest. (C) Maximum intensity projection image of
  FDG PET/CT scan shows diffuse hypermetabolic disease in chest, liver, and bones. (D)
  Lung window images during FDG PET/CT scan showing bilateral small pulmonary nodules.
case_images: 10.1177_11795441221145937-fig1.jpg
case_images: PMC10160796_01_10.1177_11795441221145937-fig1.jpg
case_images: fig1-11795441221145937
case_images: Enlarged mediastinal, bilateral hilar, bilateral axillary, abdominal, and pelvic lymph nodes were noted (Figure 1A to D).
case_images: (A) Liver biopsy showing non-caseating granulomas replace a large portion of hepatic
  parenchyma (H&E 20X). (B) Liver biopsy showing numerous non-caseating granulomas
  (white arrow) composed of tightly packed epithelioid histiocytes without associated
  necrosis, caseation, or acute inflammation (H&E 40X). (C) Liver biopsy showing rare
  Langerhans-type multi-nucleated giant cells are associated with the granulomas (white
  arrow) (H&E 40X).
case_images: 10.1177_11795441221145937-fig2.jpg
case_images: PMC10160796_01_10.1177_11795441221145937-fig2.jpg
case_images: fig2-11795441221145937
case_images: The liver was almost completely replaced by back to back non-caseating granulomas (Figure 2A). These granulomas were small and composed of tightly packed epithelioid histiocytes without associated necrosis, caseation, or acute inflammation (Figure 2B). Rare Langerhans-type multi nucleated giant cells were noted (Figure 2C).