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Histopathology (H&E stain) of the meningeal biopsy. Granulomatous meningitis with diffuse, deep infiltration of the dura by inflammatory cells (A, magnification ×40); higher power view (B, magnification ×100) showing lymphocytes, plasma cells and scattered histiocytic granulomas with multinucleated giant cells. Some granulomas reveal central necrosis (C, ×100). Multinucleated giant cells are clearly seen (D, ×200).
