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Old 08-02-2011
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A 45-year-old patient who received a kidney transplant 3 months prior presents with a 2 week history of cough and malaise. In this patient, a pulmonary cytomegalovirus infection would be supported by which of the following?
A. Epithelioid cells with necrotic debris in fine needle aspirate
B. Pleural fluid with atypical mesothelial cells
C. Cysts staining with GMS in bronchoalveolar lavage fluid
D. Malignant appearing squamous cells in sputum
E. Intranuclear inclusions in large epithelial cells in bronchoalveolar lavage fluid
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Old 08-02-2011
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Originally Posted by ricko335 View Post
A 45-year-old patient who received a kidney transplant 3 months prior presents with a 2 week history of cough and malaise. In this patient, a pulmonary cytomegalovirus infection would be supported by which of the following?
A. Epithelioid cells with necrotic debris in fine needle aspirate
B. Pleural fluid with atypical mesothelial cells
C. Cysts staining with GMS in bronchoalveolar lavage fluid
D. Malignant appearing squamous cells in sputum
E. Intranuclear inclusions in large epithelial cells in bronchoalveolar lavage fluid
the ans is E
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Old 08-02-2011
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E. Intranuclear inclusions in large epithelial cells in bronchoalveolar lavage fluid
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Old 08-02-2011
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E) intranuclera inclusions
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Old 08-03-2011
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yup the ans is EEEE
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Correct Answer answer

Cytomegalovirus infections are particularly serious in immunocompromised patients, such as those taking immunosuppressant medications after organ transplantation. Bronchoalveolar lavage demonstrating large epithelial cells with intranuclear inclusions is consistent with CMV infection.

Lung cancer will show malignant squamous cells in sputum. Granulomatous inflammation (mycobacterial and fungal) will show epithelioid cells with necrotic debris. Mesothelioma will have pleural fluid with atypical mesothelial cells. Pneumocystis carinii pneumonia is a diffuse process in immunocompromised patients and will show cysts staining with GMS in bronchoalveolar lavage.
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