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This is a rare entity and it is good to see. Thanks for the posting. Is there a history here? I’d love to hear your thoughts on how you came to the diagnosis.

----Comment by: Iago on 4/29/2009 6:37:18 PM

I think the most suggestive feature is the "fibrin ring granulomas", which to me look like a droplet of fat surrounded by a granuloma. They are characteristic (but not specific) for Q fever.

----Comment by: kyouens on 4/30/2009 6:29:18 AM

Don't forget that we usually get Masson trichrome on livers - the fibrin ring stains bright red. Classic board exam material here, Kyouens!

----Comment by: GIPathDoc on 5/12/2009 10:14:59 AM

     

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