Systemic visceral talc granulomatosis associated with miliary tuberculosis in a drug addict

Light and scanning electron microscopic study of tissues obtained at biopsy and at autopsy from a 64-year-old male drug addict revealed the presence of foreign body granulomas associated with birefringent crystals in the lungs, liver, bone marrow, spleen, and lymph nodes. Caseating granulomas associated with Mycobacteriaceae tuberculosis were also present. Energy dispersive X-ray analysis identified the crystals as talc. Minute talc crystals were also visualized in urine sediment, by scanning electron microscopy and identified by energy dispersive X-ray analysis.