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The tracheobronchial lymph nodes were firm and enlarged up to 6 \u00d7 4 \u00d7 3 cm; the thoracic aorta and carotid arteries were lined by hard, tan-white, mineralized intimal plaques. Histologic examination of lung revealed numerous 10\u201320 \u03bcm diameter yeasts with clear 1\u20132 \u03bcm thick double-contoured walls, central basophilic nuclei, and frequent broad-based budding, consistent with Blastomyces dermatitidis. DNA sequencing confirmed the diagnosis. 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