Case 3-4 . Demonstrates focus of epithelioid macrophages replacing normal hepatic cords. These cells are filled with ill defined rod shaped structures. Case 3-4 . Similar clusters of epithelioid macrophages and lymphocytes expand alveolar septa near moderate sized blood vessels.
Macrophages contain granular to rod shaped material.
Cell clusters adjacent to vessels like those described above contain myriad acid fast bacilli. Hepatitis, granulomatous, portal, central, and multifocal, moderate, with numerous intrahistiocytic bacilli. Pneumonia, granulomatous, perivascular, multifocal, moderate, with numerous intrahistiocytic bacilli. Congestion, diffuse, moderate, with abundant alveolar edema.