Fig. 4

CT images of the patient's abdomen, B-ultrasound and puncture pathology of the subcutaneous nodules of the abdominal wall. A, B show two nodules under the skin of the abdominal wall, as shown by the yellow and red arrows. The blue arrow shows the subcutaneous strip of high-density shadows, suggesting inflammation. C Shows enlarged spleen. D is a B-ultrasonic image of abdominal wall nodules. There is a 37 mm × 20 mm, 24 mm × 14 mm mixed echo group in the fat layer of the left abdominal wall, with irregular shape, uneven internal echo, and insignificant internal blood flow signal. Under ultrasound-guided puncture of the left abdominal wall nodule, the pathological image is shown in E (Hematoxylin and eosin staining of the nodule, original magnification × 200. Scale bar = 50 μm). Microscopic images were taken with VS200 Slide Scanner (Olympus, Tokyo, Japan) at a resolution of 1880 × 1048 pixels, analyzed with Olyvia software (Olympus). A large number of inflammatory cells including lymphocytes and neutrophils are seen, as well as some pus cells which are fragments of inflammatory cells. A few fibroblasts can be seen among inflammatory cells. Colony smear showed filamentous fragment forms of Acid fast bacilli by Acid-fast stain in F (Original magnification × 1000. Scale bar = 5.0 μm). Microscopic images were taken with VS200 Slide Scanner (Olympus, Tokyo, Japan) at a resolution of 1560 × 920 pixels, analyzed with Olyvia software (Olympus)