Sunday, May 15, 2011

Answer to Case 161

Answer: Ascaris lumbricoides eggs (most appear unfertilized) surrounded by neutrophilic inflammation and necrosis.

This was definitely a challenging case, but the clues for diagnosis were as follows:
1. Size of eggs
2. Presence of external mammilations on the eggs, characteristic of Ascaris eggs
3. Presence of Ascaris eggs in the patient's stool, confirming the presence of intestinal ascariasis.
4. CT findings suggestive of bile duct obstruction (consistent with the presence of the adult Ascaris female worm in the bile duct - a rare but potentially serious complication.

Thanks to all of you that decided to take the plunge and submit an answer!

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