September, 2005

Case 163:
A 45-year-old man was admitted to a local emergency room in a comatose state after apparently having a heart attack.  The man never regained consciousness and expired the next day.  His patient history, gathered from his wife, included high blood pressure and high cholesterol levels as well as complaints of abdominal pain, intermittent diarrhea, noticeable weight loss, frequent headaches, and occasional shortness of breath for the past 5 months.  His wife stated that he had been working abroad for one year in the Philippines and had just returned home for a one-week visit.  An autopsy was performed to determine the cause of death.  Figure A shows an image captured from a hematoxylin and eosin (H & E) stained slide of a section of intestinal tissue.  Although not the cause of the man's death, what is your diagnosis of this incidental finding?  Based on what criteria?

A

Click here for the answer to Case 163.

Case 164
A 42-year-old animal trapper sought medical attention regarding an ulcerative lesion on his arm (Figure A).  He reported that he had been in Bolivia two months ago and that the lesion on his arm had grown worse since his return.  A biopsy of the lesion on his arm was performed and a touch prep smear prepared and stained with Giemsa.  The tissue was sent to pathology to be sectioned and stained with H & E.  Figures B and C show objects observed on the Giemsa stained touch prep smears, and Figures D and E show objects observed on one of the H & E slides.  What is your diagnosis?  Based on what criteria?

A

B	C

D	E

Click here for the answer to Case 164.

Images presented in the monthly case studies are from specimens submitted for diagnosis or archiving.  On rare occasions, clinical histories given may be partly fictitious.