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…tinct fibrillar appearance in some areas. This is most evident in Figure 2. Of note, small clusters of hepatocytes laden with lipofuscin pigment were found in close association with the mesenchymal cells (Figure 4). Cells with morphology consistent with the respiratory tract were not found. The background was bloody. Given that the aspirate was submitted as a pulmonary mass, a diaphragmatic hernia was considered a leading differential. This would…

…). Lymphoplasmacytic portal infiltrates and mild suppurative infiltrates were noted associated with copper-laden hepatocytes, which were found randomly throughout the lobules, but most were in the centrilobular zone. The presence of copper was confirmed with rhodanine staining (Figure 4) and portal and mild dissecting fibrosis was identified on a reticulin stain. Most of the hepatocytes displayed cytoplasmic distention, compatible with…

…Answer on next page Interpretation Mixed neutrophilic, histiocytic inflammation with intracellular carbon compatible with smoke inhalation Explanation Direct smears were of high cellularity due to large numbers of non-degenerate neutrophils with fewer but still numerous macrophages also present. Macrophages were highly vacuolated, containing moderate to abundant amounts of black granular pigment (Figure 2a). The pigment was negative on a Pr…