Katherine Kasper, MD, Fellow, Department of Cytopathology
Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
CASE HISTORY:
The patient is a 46 year-old male with a history of type 1 diabetes mellitus who had undergone a pancreas transplant several years ago and was on a course of immunosuppressive drugs to prevent organ rejection. He presented with chills, night sweats, weight loss, cough, and shortness of breath. CT imaging revealed mediastinal lymphadenopathy and multiple lung nodules throughout both lungs. CT-guided core biopsy was performed on the largest (1.5 cm) lung nodule. Touch preparations were made during on site adequacy evaluation/triage by Cytopathology.
 |
| Fig. 1 DQ-stained touch preparations |
 |
| Fig. 2 H&E-stained core biopsy |
 |
| Fig. 3 Gomori methenamine silver-stained core biopsy |
Your diagnosis?