Monday, September 14, 2015

Case of the Week 364

This week's case was generously donated by MicrobeMan (Dr. Ryan Relich) and Dr. Dibson Gondim. The patient is a 70-year-old male with a conjunctival lesion that was surgically resected. It doesn't appear that he has travelled outside of the United States.

Here are some photos from the H&E-stained sections. Diagnosis?




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10 comments:

  1. AnonymousSeptember 15, 2015 at 12:05 PM

    I think is toxocara so from a dog or cat. I don't know what the alternatives would be if there was a history of foreign travel.

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  2. AnonymousSeptember 15, 2015 at 12:15 PM

    Dirofilaria sp.
    I'm not good at tissueparasites though :)

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  3. AnonymousSeptember 15, 2015 at 4:04 PM

    My guess is Toxocara possibly canis. Reading pathology smear is not my forte therefore I remain a scholar.

    Florida Fan

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  4. UnknownSeptember 16, 2015 at 9:47 AM

    I would say the presentation and the morphology is consistent with Dirofilaria sp.
    The longitudinal ridges can be clearly seen which, along with the location, led me to the diagnosis. They does seem to be some unusual internal morphology, which is not exactly what I would expect to see, as I would expect to see 2 reproductive and 1 digestive tracts, when only 1 is clearly visible here. Could this be due to damage caused by infiltrating leukocytes? Picture 3 seems to support this since you can see what appear to be leukocytes in the worm body.

    I am not exactly certain of this, but that is about as close as I could get.

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  5. AnonymousSeptember 16, 2015 at 2:27 PM

    Looks like some kind of worm. Not sure if Dirofilara, Toxocara or Thelazia??

    Hi Ho Hi Ho, off to Mayo we go! LOL

    Lee

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  6. ParasiteGalSeptember 16, 2015 at 5:54 PM

    Hi Lee, when will you be at Mayo? Unfortunately I'm gone this weekend and most of next week, but I'll be back by the following Friday, the 25th. I'd love to meet you in person, and would be happy to show you around my lab if you were interested. Just let me know. Bobbi

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  7. AnonymousSeptember 17, 2015 at 1:43 AM

    Arthur Morris:
    After further study, I believe you're right.

    Florida Fan

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  8. AnonymousSeptember 18, 2015 at 7:08 AM

    LOL! I meant the slides...not me! You (Mayo) are our reference lab.. Besides, Minnesota is only for summer for me!

    Lee

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  9. ParasiteGalSeptember 19, 2015 at 7:42 AM

    Lee, too funny! Well, if you ever make it to Miinesota yourself, you're always welcome to stop in for a visit!

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  10. UnknownSeptember 21, 2015 at 2:13 PM

    Very nice pics again !
    The location of the worm together with microscopic examination of cross sections after HES staining highlighting longitudinal ridges on the cuticle (multilayered), suggest Dirofilaria repens (Nematodes). Lateral chords can be seen on figure 2 and 3.
    Thanks
    Florent

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