The following structure was coughed up by a 70-year-old woman with advanced stage lymphoma. She had recently received chemotherapy consisting of rituximab, ifosfamide, carboplatin and etoposide (R-ICE). At the time, she was quite ill and in the intensive care unit. Likely identification?
11 comments:
If critically ill, I'd say strongyloides, but I don't know what I'm looking at here. Looks like she coughed up half of her alveoli!
Hmmm . . . I'm leaning toward a bronchial cast of some sort - perhaps related to her chemotherapy. would want to "dig around" in there a bit using the stereoscope to be sure, but don't think it's a helminth.
Definitely not a parasite. After searching for compatible images, my guess is like this: The seemingly segmented portion resembles the end portion of a bronchus and the tubular portion being the terminal bronchiole leading to the alveoli.
Trust me, I have been wrong before and this is my only guess.
Florida Fan
Bronchial cast makes sense; I've seen similar from the colon, but much larger than this.
A tracheo-bronchial pseudomembrane....? diphtheria?
Congratulations, Bobbi, on your ten years!
bw in vt
Ascaris lumbricoides. This is rare in US, but it could be coughed up.
Agree w Ascaris lumbricoides, by size and head conformation. See Case 456 for a video of these worms alive in a small intestine by endoscopy...ugh!
Not a parasite, definitely. Bronchial Cast would be my guess.
Answer, please?
It's now posted online - just scroll down the web page.
Thanks!
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