Sunday, February 28, 2016

Case of the Week 387

This week's case was generously donated by Dr. Heidi Lehrke. These objects were seen in a lymph node aspirate specimen.

May-Grunwald-Giemsa, 600x
May-Grunwald-Giemsa, 1000x


Identification?
How did they get into the specimen?

16 comments:

germsandworms said...

Trichomonas!

Camila Coelho said...

Giardia duodenalis. Binucleated, 4 pairs of flagella.

celeste pereyra said...

Giardas

dr Rashid Yaqoob said...

Trichomonas

Khalid Elfeel said...

Giardia Trophozoite
2 nuclei
4 pair flagella
falling leaf motility !!

Anonymous said...

Giardia. But how did it get into the lymph node?

Anonymous said...

Giardia...where was the lymph node (anatomically?)

Lee

Anonymous said...

Trophozoite of Giardia duodenalis due to the presence of 8 flagella and two nuclei. Giardia typically remains contained to the GI tract, so perhaps the lymph node was being sampled through the small intestine. The presence of intestinal epithelium in the cytology sample would be helpful in confirming the specimen was obtained in such a manner if the approach of the procedure or location of the lymph node was not known.

Anonymous said...

Giardia. Was this a trans-duodenal aspirate?

Anonymous said...

These trophozoites of Giardia lamblia cannot be stained any better. It's not always easy to stain all the flagella, parabasal body and axiostyle all at the same time. I suspect there was a incidental aspiration of the intestinal contents while performing the lymph mode aspiration.

Florida Fan

aline oliveira said...

TROFOZOƍTOS DE Giardia lamblia

William Sears said...

Giardia

William Sears said...

Giardia; perhaps there was contamination during procedure if the sample was from an abdominal lymph node and bowel was punctured during the attempt. Or maybe there was a bowel resection performed during a oncologic procedure requiring regional lymphnode sampling as well.

Eric said...

Strange for that type of aspirate but looks like Giardia!

AJ Shepherd said...

Looks like Giardia to me, you can see both nuclei if you look closely. How did it get in there? Maybe contamination during sampling? I know that some parasites will disseminate in immunocompromised patients, but I had not heard of that happening in Giardia.

Guillermo Comach said...

Giardia lamblia Being a luminal intestinal parasite How did it get into the lymph node?