Sunday, May 20, 2012

Case of the Week 209

The following liver biopsy is from 6 year old girl. 

Hematoxylin and eosin (H&E), 200 times original magnification

 H&E, 400 times original magnification 

H&E, 1000 times original magnification
Based on these findings alone, what is your differential diagnosis?

The following object was found in the soil from the backyard where she frequently played.

 Unstained, object measures approximately 60 microns in diameter



Anonymous said...

Toxocara sp.

Bill said...

Looks like Visceral Larva Migrans due to Toxocara canis or cati.

She probably lives in the Southern US.
One differential would be a liver invasion of Capillaria hepatica.

Musigny1955 said...

Toxocara cati or canis, causing visceral larva migrans (thus the liver biopsy), in a child who accidentally the egg. Baylisascaris procyonis would be part of the differential however the Baylisascaris egg is larger, and in the biopsies I can't see any lateral alae.....

Anonymous said...

Ascaris lumbricoides

Anonymous said...

In opposition to the above mentioned I don´t think that the picture resembles Ascaris lumbricoides, because the outer cover is not undulated and the egg is not round enough.
It is conceivable that the pictured item is not the cause of the lever granuloma.

Anonymous said...

the egg is relatively small for a Toxocara egg so I would go for Toxocara cati

Salbrent said...

Toxocara embryonated egg
It's infectious, too
Cool pic, thanks for sharing

Anonymous said...

Hello, I agree with the Toxocara egg in the last two pictures, but I think that the lever pictures showed another kind of egg, it is more oval than the other egg.

Anonymous said...

The picture of the liver is the larvae stadium