April, 2009

Case 249
A small worm approximately 2.5 cm in length was recovered from the stomach of a 38-year-old male.  The anterior end had been damaged by the extraction but it was sent to the CDC to see if it could still be identified.  It was placed in lacto-phenol for clearing, after which it was still difficult to make a definitive identification.  A small cross-section was made and examined using a compound microscope.  The specimen in Figure A was captured at 40x magnification using brightfield illumination; the specimen in Figure B at 200x using differential interference contrast (DIC) microscopy.  What is your diagnosis?  Based on what criteria?

A	B

Click here for the answer to Case 249.

Case 250
A 45-year-old man developed a few ulcerative lesions on his left forearm about one month after returning from a nature excursion in Costa Rica.  He was referred to an infectious disease specialist by his primary care provider.  A biopsy was obtained from the rim of one of the lesions, and subsequently sectioned and stained with hematoxylin and eosin (H&E).  Figures A and B show what was observed on one of the slides.  What is your diagnosis?  Based on what criteria?  What other testing would you recommend?

A	B

Click here for the answer to Case 250.

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.