Since I am moving things from my NAME-directed activities to more general availability, the NAME-oriented “Billo’s Pretty Pics” series has been discontinued.\u00a0 Instead, I will be posting cases to this blog.\u00a0 Over the next few months, I will resurrect the more interesting photos from Billo’s Pretty Pics.<\/p>\n
This is the first in the new series.\u00a0 This is the case of a late-middle-age person who came to the hospital complaining of shortness of breath.\u00a0 Initial evaluation was suspicious for COVID-19, but initial tests were negative.\u00a0 Further workup revealed multiple large pulmonary thromboemboli, which were removed.\u00a0 Nonetheless, the decedent’s respiratory status declined and he or she passed.\u00a0 An autopsy was requested to determine cause of death.<\/p>\n
At autopsy, there were numerous pulmonary infarctions, which, upon histology revealed numerous small pulmonary emboli.\u00a0 Small fibrin emboli were noted in other organs, but no large infarctions were noted.\u00a0 The lungs also showed mild emphysematous changes, but no evidence of interstitial pneumonia or diffuse alveolar damage.\u00a0 Repeat COVID testing was negative.\u00a0 As an incidental finding, the pituitary was mildly enlarged.\u00a0 When I looked at it, I didn’t notice a discrete tumor, but I’m sure that if I went back and looked, I likely would.\u00a0 In any case, on histologic examination there was a proliferation of monotonous looking plasma cells:<\/p>\n <\/p>\n On closer examination, it appeared to consist of plasma cells:<\/p>\n <\/p>\n At that point I went back and submitted some bone marrow.\u00a0 Sure enough, his marrow was full of plasma cells:<\/p>\n <\/p>\n Here’s a closeup:<\/p>\n![\"Sella](\"https:\/\/wordpress.forensicpath.us\/wp-content\/uploads\/2020\/09\/Composite-scaled.jpg\")
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