Histologic changes: This multinucleated giant cell contains a T-shaped foreign body (arrow) of unknown type. It was birefringent when viewed with polarized light.

In contrast to the unidentified foreign body shown above, this structure (arrow), surrounded by a corona of epithelioid cells, is diagnostic. What is it, and what is the diagnosis of this man's pneumonia? Answer

When this type of foreign body is stained with PAS-D, the central pale, round parts are positive.

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Answer: This foreign body is a fragment of pulse. Pulses are seeds of leguminous plants--beans, peas, lentils, peanuts. When these particles are found in the lung, they are diagnostic of aspiration. The diagnosis is aspiration pneumonia.

Clinical summary Image 4

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