September, 2009

Case 259
A four-year-old child was admitted to the hospital for sever abdominal pain mimicking appendicitis.  A small section of bowel was removed and sent to the Pathology Department for work-up.  A section of tissue was preserved in formalin, sectioned, and stained with hematoxylin and eosin (H&E).  Images A-C show what was observed at 100x magnification of slides made from the tissue specimen.  In addition to the biopsy, stool was collected for routine ova and parasite (O&P) examination.  The object is Figure D, which measured on average 73 micrometers long by 37 micrometers wide, was seen in low numbers in a concentrated wet mount from a formalin-preserved aliquot of the stool.  What is your diagnosis?  Based on what criteria?

A	B

 

C	D

Click here for the answer to Case 259.

Case 260
A 47-year-old woman presented a worm-like object to her doctor that she claims was found in the toilet following urination.  The object, which measured seven millimeters in length, was preserved in formalin and sent to the local state health laboratory, which in turn sent the specimen to DPDx for diagnostic assistance.  Figure A shows the entire object.  Figures B and C show the anterior and posterior ends of the object, respectively.  What is your diagnosis?  Based on what criteria?

A	B

 

C

Click here for the answer to Case 260.

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.