Bronchial Adenoma with the Carcinoid Syndrome Presenting with Unusual Skin Changes.

Histology: The brain, meninges, spleen and kidneys showed the fungus, which appeared as small spheres reproducing by budding. The lesions in the brain were meningeal and perivascular in the basal ganglia. The lesions in the brain and spleen had a minimal tissue reaction. In the liver and kidneys there were miliary collections of histiocytic cells containing the fungus. The firm nodule in the lung showed fibrosis, chronic inflammatory cells and two giant cells. There was no evidence of the fungus. It was not possible to be certain whether this was the primary focus of infection.