Monday, March 19, 2018

Case of the Week 486

For this week's case, I'm going to take advantage of whole slide imaging technology via the cloud. The patient is a middle-aged male smoker from the southern United States who presented with shortness of breath, and imaging revealed a lung nodule. Because of concern for malignancy, the nodule was excised and sent to pathology for analysis. Here is a representative image of the nodule:

Click HERE to zoom in and explore this slide! You don't need any special password or software to view the case.

Diagnosis?
Bobbi

8 comments:

Anonymous said...

It certainly looks like a cross section of a nematode though I cannot say which one. This case is going to be tough to crack.
Florida Fan

Adolfo from Bolivia said...

Pulmonary dirofilariasis, very nice picture!

Idzi P. said...

Although I have no experience with histological slides, my educated guess would be to agree with Dirofilaria. It seems indeed that we see a filarial nematode in the section. The fact that the cuticle seems smooth, would confirm it to be D. immitis, as all other Dirofilaria spp. have longitudinal ridges on their cuticle. It is important to differentiate pulmonary dirofilariasis from malignancies, as both can present as “coin-lesions”.

Blaine Mathison said...

Interesting, this is clearly Dirofilaria (coelomyarian/polymyarian musculature; large lateral chords; internal ridge running along the base of the lateral chords) and the clinical presentation and lack of obvious cuticular ridges suggests D. immitis. However, this appears to be a sexually-mature adult (which is unusual in the human host).

Idzi P. said...

I’m not very familiar with histological slides, but it’s really fun looking around in this preparation, using the WSI technology! Zooming in, zooming out, sliding, panning.. (I have no clue what “panning” is, but it sounds good, no?)... Awesome software! Really awesome! Works best on pc or laptop, but also gives acceptable results on mobile devices! My compliments to Dr. Norgan!

mona said...

Dirofilaria spp. (solitary nodule in the lung)

Atiya Kausar said...

Awaiting for your detailed explanation..... thanks for sharing a new way of seeing whole slide

Membuat Pupuk Organik dari Kotoran Sapi said...

that looks like some alien nest,