case_images: PMC10807272_01
case_images: (A) Shows gross hepatomegaly and splenomegaly. (B) Shows the spleen after splenectomy was done.
case_images: JBM-15-1-g0001.jpg
case_images: PMC10807272_01_JBM-15-1-g0001.jpg
case_images: f0001
case_images: She had a non-tender moderately distended abdomen, with a massive hepatosplenomegaly (spleen 8cm below the coastal margin and liver 12 cm below the coastal margin) (see Figure 1). Figure 1A and B). These events are summarized in the attached timeline figure (see Figure S1).
case_images: Both panels (A and B) are bone marrow smears showing large cells (macrophages) with multiple hyperchromatic eccentric and nuclei with abundant bluish cytoplasm (Gaucher cells) (X400, Giemsa stain).
case_images: JBM-15-1-g0002.jpg
case_images: PMC10807272_01_JBM-15-1-g0002.jpg
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case_images: Smears were stained with Giemsa (see Figure 2A and B) while trephine biopsy was stained with H&E and these revealed Gaucher cells) which are weakly periodic acid Schiff (PAS) positive (see Figures 3A-D).
case_images: (A) Low power Images of the trephine biopsy showing a hypercellular marrow (100% cellularity) with numerous large cells with abundant pink cytoplasm crowding out all the hematopoietic cells. (B) high power view (x400) of the same marrow showing Gaucher cells with wrinkled tissue paper cytoplasm. (C) High power view of the trephine biopsy showing Gaucher cells weakly positive for periodic acid Schiff (PAS). (D) Histology section of the spleen showing sheets of macrophages (Gaucher cells) with abundant amphophilic cytoplasm and scattered residual lymphocytes.
case_images: JBM-15-1-g0003.jpg
case_images: PMC10807272_01_JBM-15-1-g0003.jpg
case_images: f0003
case_images: Smears were stained with Giemsa (see Figure 2A and B) while trephine biopsy was stained with H&E and these revealed Gaucher cells) which are weakly periodic acid Schiff (PAS) positive (see Figures 3A-D).
case_images: X-ray of the femur taken 5 weeks after splenectomy showing early musculoskeletal changes in the bones (Erlenmeyer flask deformity in the right femur).
case_images: JBM-15-1-g0004.jpg
case_images: PMC10807272_01_JBM-15-1-g0004.jpg
case_images: f0004
case_images: Lower limb x-ray revealed early skeletal deformities (Erlenmeyer flask deformity) (see Figure 4) involving the metaphysis of the femur.