Monday, December 10, 2018

Case of the Week 522

This week's case features a whole slide image (WSI) of an H&E-stained section from a bladder resection. You can access the WSI HERE. Like the other WSIs that I've features on my blog, you don't need any special software or a log-in username to access the image. You can easily use the track ball on your mouse to zoom in and out. If using a smart phone or tablet, you can pinch in or out to zoom. Enjoy! (P.S. there are 2 things of interest on this slide).



15 comments:

eob said...

Looks like S. haematobium adults (in their embrace) and ova

Anonymous said...

Really neat slide that illustrates what looks like S. hematobium within the venules. Great for teaching!

Rasta Bob said...

Bobbie - I have always wondered - how do the eggs get from the venules outside the bladder to the inside of the bladder and out?

Old One said...

Looks like female, male, and eggs of S. haematobium. The embrace (thanks eob) of the female by the male is unique to the "Schistos" for a couple reasons. Schistosomes derives from Greek meaning split of cleft body. This particular cleft is a split between male and female reproductive organs, making it dioecious (separate sexes) where other flukes are monoecious (both sexes in one individual). The small size of female to male is the second unique feature. This allows the female to break the embrace and swim down the smaller capillaries to deposit its eggs closer to the mucosal surface than if it were in a bulkier monoecious form, thereby being closer to the external environment. Improving the survival of the egg.

Anonymous said...

Acanthamoeba/Balamuthia???

Old One said...

1. Upon further examination of slide, I believe I'm seeing hatched miracidia.

2. Keeping with the discussions of parasites effecting the behavior of it's host to enhance survivability. I would like to mention another species of Schistosome which may modify behavior, not of the host but rather an unrelated species.

Schistosoma nasale (south Asia) inhabits the blood vessels of the nasal mucosa of cattle causing cauliflower like growths which blocks airflow forcing cattle breath loudly resulting in what's called "snoring disease".

During the quiet of the night one can hear the "snoring cattle". It does not sound like human snoring, but rather the muffled roar of Tigers. Parents take advantage of this by telling their children at bed time that if they are naughty the prowling Tigers will come to their bedrooms and "get them". Hopefully this will change the childs behavior in a positive way.

Yes, this is a stretch of 'the power of parasites " over behavior, but I like this story.

Asmaa kamal said...

It seem to be schistosoma haematobium egg trapped in bladder wall

Anonymous said...

Folks,
My practice does not involve "cut worms". As a result, I remain to be taught. One confession, it is always so interesting to read everyones' comments. There is nothing as entertaining as the comments on the Blog.
Florida Fanl

Blaine A. Mathison said...

I never commented but generally everyone is on the right track: adult male and female S. haematobium [i]in copula[/i] and shed eggs in the surrounding tissue, eliciting a classic neutrophilic/eosinophilis granulomatous host reponse.

Old One: hatched miracidia unlikely; I am not sure what you are looking at maybe just the angle of cuts in some of the eggs are highlighting the miracidia. Now, you do see fully-developed miracidia in tissue, since the eggs are shed embryonated.

Old One said...

Thanks Blaine, like Florida Fan, I am here to be taught.

I believe I am seeing eggs without shells (miracidia). Where am I going wrong?

Bernardino Rocha said...

I agree with all of the above. It appears to be adults of S. haematobium and ova. Sometimes it can be mistaken for bladder cancer, as described in the following article:

https://watermark.silverchair.com/labmed46-0338.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAk8wggJLBgkqhkiG9w0BBwagggI8MIICOAIBADCCAjEGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMG3oUATv5k0L2-xWRAgEQgIICAtgAYqJ61cE0k8Hg_J5QX3BlizLPyCehKx6yli5T3phs8_55zKD4Z0KpnH8nk5SzHjw0c-9F7ieecZP2_I1IBGi1WkOSAvTThFGXZW4cxoQhlwVJQlzjPrcw2_Qv7iy7SnqaHsRkmYosulF8VuHZup8ju4hSIv-yduHJ1PfL044VPbTLdPji7nU1Bxo6rW0PU6MyfDqAlUgUWAJB3Is-Fszw7EebceW_BMjM8are3LcaxHMcIs_b8hUGyzM25xlQLYFWrGYJgsOxvxfLceSa4Do8G6OEZvo6MX3euUDEm6M2oWcA5hYfwjhIxpSmvnyzC3ynwFZNfTdtvn2SqXvkwzzVS1xhfHfQBn5aGnQtQQ4Lyc0UQV9xtdzFiOEJWjegIc8TKru1qyM_GziKjUbh90hf9Krmt0rK6tswOLykFCywI1SNchqqL-RPvIw6lExkQfGggBLr5eW_yQDIxCmeKHevFHVeowbWIoQAhITB4Tb53y3QSh8o_6sZN1RyamZVzUHEYsnfIHG2YhTS1sldQCgp276QM0439wb2raljn7qv47Z6AbRKHlg0Yl3mExrPyKevVGUb-V6poL5AJA8MrrQe7Xk-bdXNT_yAQLYbR4Dl5ndqeZB2l-YAqEvbm_kba8WjXIvSxO0Wt5wYCpv_KH46suY_aK9ZXE7spAA9j0pSTuY

Bernardino Rocha said...

Access here: https://academic.oup.com/labmed/article/46/4/338/2937902

Bobbi Pritt said...

Old One, if you look closely, you should be able to make out the shells. They are damaged during processing and therefore aren't nice and rigid as you would see in urine. thank you for the great comments and the story above!

Old One said...

I do see the refractive remnants of the shell on many of the eggs. I can imagine those tiny delicate refractive rings being lost during processing.

Thank you all.

William Sears said...

Adult S haematobium in section. Also, eggs migrating toward mucosa