Clinical Information

• 62 YO, M, H/O diabetes; Smoker-16 yrs, 2-3 PPD; Traveled a lot in US last year.

• For 2 yrs, increasing weakness/fatigue, loss of 80 pounds;

• Over the past months, fever/night sweats, cough with yellow/green sputum;

• He was then admitted and found to have:

  • Bilateral apical cystic changes of the lung;

  • TB test positive;

  • distended gallbladder and intrahepatic bile ducts;

  • Marked dilation of the pancreatic duct with possible distal pancreatic necrosis.

  • SAIDH, hyponatremia, hypokalemia and high bicarbonate;

  • Pronounced dead two weeks after admission. Autopsy perform.

• Examinations of the lung are presented here, and examinations of the pancreas are in case 46.

Gross Examination

Microscopic Examination

Caseating Necrosis - RUL. HE, 20×

AFB, 60×

Click here for diagnosis and case discussion.

Source: Department of Pathology, Creighton University Medical Center, Omaha, NE

Photo: Zenggang Pan

Discussion: Zenggang Pan