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Histopathology of lung biopsy specimens from patients A1, B1, and B2 (hematoxylin and eosin staining). The findings were similar in all 3 patients and showed severe proliferative diffuse alveolar damage with large, bizarre, hyperchromatic nuclei (black arrows), suggestive of a DNA repair defect. Patient A1 also had multiple eosinophils (white arrows).
