case_images: PMC10569663_01
case_images: (a). May-Grunwald-Giemsa stain of patient's bone marrow aspirate showing active haemophagocytosis (arrows). Erythroid hyperplasia, with mild reactive dysplasia, at several maturation stages can be observed. Reversal of the normal myeloid/eryhroid ratio is also shown. Of note, myeloid lineage is maturing without morphologic abnormalities. Light microscopy, x100. (b). May-Grunwald-Giemsa stain of patient's bone marrow aspirate showing active haemophagocytosis of erythroblasts (arrows) from bone marrow stromal cells (arrow heads). Marked erythroid hyperplasia and reversal of the normal myeloid to erythroid ratio is again depicted. Light microscopy, x100. (c). Hematoxylin-eosin stained histologic section of bone marrow biopsy specimen showing a well-formed granuloma with several histiocytes (arrow heads) and a Langerhans giant cell (arrow). Light microscopy, x40. (d). Histologic section of bone marrow biopsy specimen stained for CD68/KP-1 showing markedly positive (brown) granuloma histiocytes. Light microscopy, x40.
case_images: acmi-5-670.v3-g001.jpg
case_images: PMC10569663_01_acmi-5-670.v3-g001.jpg
case_images: F1
case_images: BM stromal cells (Fig. 1a, b). Bone marrow histology revealed well-formed non-caseating granulomas with several histiocytes and a Langerhans giant cell (Fig. 1c, d). BM Ziehl-Nielsen staining and cultures in Lowenstein-Jensen medium as well as Mycobacteria Growth Indicator Tube (MGIT) for Mycobacteria were all negative.