The spleen has distortion of the normal architecture. There are no distinct white pulp nodules. Multiple, large, pale areas are seen mixed with smaller hemorrhagic areas. The paler areas correspond to foamy eosinophilic macrophages.
Some cells contain foamy eosinophilic material.
Occasional large cells may correspond to megakaryocytes and there are occasional nucleated cell which may represent red cell precursors. A pulmonary hilar lymph node shows complete effacement of the nodal architecture. However, there are numerous plump, foamy macrophages which when considered show the marrow cellularity to actually be decreased. The bony trabeculae are thinned. There is very little to no active hepatitis.