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Oral Ulcers with Weight Loss


A 66-year-old male presented with oral pain during eating and a 30 lb weight loss over 2 months. He resided in California but grew up near New Orleans. He last visited New Orleans 9 months before the onset of symptoms. A workup and history were negative for immunodeficiency. Exam revealed tenderness over the gingiva, base of the tongue and ulcers on the soft palate (Fig. 1). Chest x-ray was unremarkable. 

Biopsy of the tongue base demonstrated non-caseating granulomas. Stainings of the tissue showed encapsulated intracellular organisms within histiocytes (Fig. 2). 

2--Encapsulated-intracellular-organisms-within-histiocytes.jpg

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Source

Source 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3515000/

 

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