Monday, October 17, 2011

Case of the Week 180

The below photographs are of H&E stained sections from an orchiectomy specimen. The patient is a Californian man with a complaint of "testicular mass." No further history is available. The questions that the referring pathologist has for you are:

1. Is this a worm or some type of artifact?
2. If it is a worm, could it be Strongyloides stercoralis or Toxocara spp.?

What do you think?

(x40 original magnification)


(x100 original magnification)


(x400 original magnification)

(x400 original magnification)

(x400 original magnification)

(x400 original magnification)

(x400 original magnification)


(x1000 original magnification)

(x1000 original magnification)
at

4 comments:

  1. Neuro_NurseOctober 17, 2011 at 8:00 PM

    That looks like encysted bradyzoites to me.
    Sarcocystis or Toxoplasma?

    ReplyDelete
  2. ladybugOctober 21, 2011 at 11:06 AM

    Filarial granuloma.
    Was the person in or from India?

    ReplyDelete
  3. AnonymousOctober 21, 2011 at 6:57 PM

    In Pathoparasitology , the classic atlas by Michael Kenney ,he says "except for W.bancrofti and aberrant eggs of schistosomes,no parasites are usually found in the testes".Thought this might help.

    ReplyDelete
  4. Neuro_NurseOctober 22, 2011 at 7:40 PM

    Testicular toxoplasmosis: a rare case of a testicular mass
    http://www.ncbi.nlm.nih.gov/pubmed/18655356

    "Toxoplasma gondii is a rare cause of orchitis, usually in the presence of widely disseminated disease or in a patient with immunodeficiency"
    Long: Principles and Practice of Pediatric Infectious Diseases Revised Reprint, 3rd ed.

    "In men with AIDS, [opportunistic infections] such as cytomegalovirus, Toxoplasma gondii, and Mycobacterium avium intracellulare have been found on pathologic examination of testes."
    Volberding: Global HIV/AIDS Medicine, 1st ed.

    "Generalized toxoplasmosis is also seen in immunocompromised patients, and involvement of liver, spleen, lymph nodes, pancreas, intestines, thyroid, peritoneum, testes, retina, and spinal cord has been documented."
    Guerrant: Tropical Infectious Diseases - Principles, Pathogens and Practice, 3rd ed.

    Toxo.

    That’s my final answer.

    ReplyDelete