(with polarized light microscopy)
Monday, March 10, 2014
Case of the week 295
The following were seen in a Papanicolaou-stained urine specimen from a 53 year old woman with chronic dysuria. She has no recent travel history outside of the U.S., but had been to parts of sub-Saharan Africa over 10 years ago. Images are shown at 400x magnification. Identification?
(with polarized light microscopy)
(with polarized light microscopy)
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14 comments:
Sure looks like Schistosoma, no? And if it's in the bladder causing urinary symptoms, you'd think haemotobium... I'm not a pathologist, but I think the little "spike" thing is also in the right spot for haematobium as opposed to mansoni when it's more on the side. Plus, she has a history of travel to Africa, which would fit.
Sure they look like Shisto but in my opinion they are artifacts, mostly urine crystals; the "membrane" is so thick to be a real membrane. The 4th picture shows a broken crystal.
Jamal
I'm also voting S. haematobium. Thanks.
I'll make it a tie again - looks like crystals and maybe urate although that is a guess.
Schistosoma intercalatum--more diamond-shaped eggs with terminal spine
Wonderful, now we have a healthy debate. In general morphology, the objects may insinuate Schistosoma ova particularly S. haematobium. Upon further observation, their sizes are not quite uniform, a character that real ova would show. another trait is their lack of internal organization. As a result, I would go with crystals.
Florida Fan
It is pointed at both ends rather than just one as seen with the ova of S. haematobium. I would say artifact. They look like uric acid crystals seen in urine.
IMHO we do not look at the Schistosoma sp. eggs (no typical inner structures, size does not fit), the objects are crystals present in urine.
uric acid crystals, the bodies are not consistant with S.haematobium (though this would be the differential) due to the lack of visible miricidium, apart from anything else.
They look like S. haematobium, but they are way to small, S. Haematobium eggs are 140 um x 60.
I go for crystals.
Hans
I'm voting artifact as well. I don't think schistosomes would be so refractile under polarized light.
uric acid crystals ofcourse
I follow you,very interesting blog.
Thank you!
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