Severe chronic diarrhea and weight loss in cholesteryl ester storage disease: A case report

Figure 1 Light microscopic findings in the liver. A: A tan-colored foamy material is seen in conspicuous macrophages next to and in a portal tract. HE stain ×400. B: Part of an acinus with a prominent intrasinusoidal cellular infiltration and a microvesicular steatosis of hepatocytes. HE stain (×400). C: An immunohistochemical staining with CD68 positive macrophages laden with the foamy material. D: Reticulin stain (×400). No remarkable fibrosis.

Figure 2 Small bowel biopsy reveals single macrophages with cytoplasmatic storage of PAS-positive foamy, tan-colored material within the apical part of the villi in the lamina submucosa. A PAS stain is demonstrated with PAS-positive macrophages between the arrows (cd) (×400).

Figure 3 A: Electron micrograph of liver tissue demonstrates a single cholesterol crystal in the cytoplasm of a liver cell. B: Triglyceride droplets of varied size in the cytoplasm of hepatocytes (×11000).