This report describes a 28-year-old woman with the acquired immune deficiency syndrome (AIDS) with culture-proven disseminated Mycobacterium avium intracellulare infection. The histopathologic and cytologic features in this case were unique in that these organisms that stained positively with the Ziehl-Neelsen and periodic acid-Schiff (PAS) stains were numerous, present intracellularly within histiocytes, transforming them into pseudogaucher cells. Differential diagnostic criteria for pseudogaucher cells and abnormal macrophage handling of the intracellular organisms in AIDS are discussed.