Cytologically Yours: Unknowns: 201310: Case 7

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Contents

Clinical History

66 yo female with a history of vasculitis on chronic immunosuppressive therapy. Currently with respiratory failure and bilateral pulmonary opacities. The clinicians asked for us to please evaluate for Cytomegalovirus and Pneumocystis jiroveci pneumonia.This specimen is a bronchial alveolar lavage (BAL) from the lingula.

Cytology

Resident Question


Additional Teaching Points

  • Patients can be asymptomatic at first
  • Some initial symptoms can include dermatitis, swelling, itching, where the parasite entered
  • Respiratory infection can be seen in immunocompromised patients
  • Patients will have hemoptysis and cough up the organism in bloody sputum
  • Loeffler’s Syndrome: eosinophils in the lungs as a response to parasitic infection
  • Parasitic roundworm