Elsevier Pathology

Anatomic Pathology: Forensic Pathology

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1188) What is the diagnosis of the pulmonary findings depicted in the images?

• In this case, a substance abuser crushed methadone and injected it into his central line while admitted in the hospital.

• The refractile foreign material is optically active under polarized light.

• Sarcoid granulomas are nonnecrotizing and may have visible intracytoplasmic asteroid bodies.

• Tuberculous granulomas are necrotizing with AFB-positive bacterial bacilli (red snappers).

Tomashefski J, Hirsch C: Microcrystalline cellulose pulmonary embolism and granulomatosis: a complication of illicit intravenous injections of pentazocine tablets. Arch Pathol Lab Med 1981;105(2):89-93.

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