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  Indian J Med Microbiol
 

Figure 1: (a-f) Initial presentation of Case 1 and 2: (a-c) Case 1: (a) Lymph node biopsy: The lymph node architecture is disrupted with extensive caseous necrosis (arrow). [H and E stain: 40×]. Inset: Note the presence of Langhans giant cells (arrow heads) adjacent to caseous necrosis [H and E stain: 400×]. (b) Bone marrow aspirate: Presence of epithelioid granulomas admixed with lymphocytes [Leishman stain: 400×]. (c) Bone marrow biopsy: Lymphoid aggregates (arrow) were noted. Occasional histiocytic aggregates were noted. Megakaryocyte (arrow head) is seen [H and E stain: 200×]. (d-f) Case 2: (d) Bone marrow aspirate: Epithelioid granulomas seen [H and E stain: 400×]. (e, f) Bone marrow biopsy: Discrete epithelioid granulomas composed of epithelioid cells rimmed by lymphocytes [Leishman stain: 400×]

Figure 1: (a-f) Initial presentation of Case 1 and 2: (a-c) Case 1: (a) Lymph node biopsy: The lymph node architecture is disrupted with extensive caseous necrosis (arrow). [H and E stain: 40×]. Inset: Note the presence of Langhans giant cells (arrow heads) adjacent to caseous necrosis [H and E stain: 400×]. (b) Bone marrow aspirate: Presence of epithelioid granulomas admixed with lymphocytes [Leishman stain: 400×]. (c) Bone marrow biopsy: Lymphoid aggregates (arrow) were noted. Occasional histiocytic aggregates were noted. Megakaryocyte (arrow head) is seen [H and E stain: 200×]. (d-f) Case 2: (d) Bone marrow aspirate: Epithelioid granulomas seen [H and E stain: 400×]. (e, f) Bone marrow biopsy: Discrete epithelioid granulomas composed of epithelioid cells rimmed by lymphocytes [Leishman stain: 400×]