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Mycobacterium Avium Intracellulare + CMV
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Mycobacterium Avium Intracellulare + CMV

The lamina propria is filled with histiocytes(black arrow) having ample pale pink granular or foamy cytoplasm
While the organism MAI can not be seen on H&E stains, the presence of clusters of characteristic histiocytes in an immunodeficiant host should create a high index of suspicion
The green arrow indicates a cell with an intranuclear inclusion diagnostic of CMV
CMV inclusions are uniformly deeply purple, occupy more than 50% of the nuclear diameter, and are surrounded by a clear zone with a rim of compressed nuclear chromatin
(Description By:Martin Nadel, M.D. )
(Image Contrib. by:Martin Nadel, M.D. UCHC )
Mycobacterium Avium Complex Infection
Etiology

Mycobacterium avium and other closely associated organisms including M. intracellulare, and M. scrofulaceum, ubiquitous in the environment.
Pathogenesis

Organisms disseminate throughout the body
Accumulate within macrophages in the lamina propria,
Epidemiology

Found in immunocompromised host, specifically patients with HIV infection.
General Gross Description

May appear normal.
General Microscopic Description

Macrophages within lamina propria contain foamy macrophages.
Numerous organisms can be identified within the macrophages with acid fast stains
Little to no inflammatory response.
Superficial resembalnce to Whipple's disease
Clinical Correlation

Part of disseminated disease.
Drug regimens to treat as well as prevent disease available.
References

Diagnostic Surgical Pathology, 2d edition, Sternberg SS (ed). Philadelphia: Lippincott-Raven,1996, pp. 1335.
Mycobacterium Avium Complex Infection
Synopsis by: Melinda Sanders M.D. (T64000E20170)[530]
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