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?
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!
ReplyDeleteHmmm . . . 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.
ReplyDeleteDefinitely 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.
ReplyDeleteTrust 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.
ReplyDeleteA tracheo-bronchial pseudomembrane....? diphtheria?
ReplyDeleteCongratulations, Bobbi, on your ten years!
bw in vt
Ascaris lumbricoides. This is rare in US, but it could be coughed up.
ReplyDeleteAgree 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!
ReplyDeleteNot a parasite, definitely. Bronchial Cast would be my guess.
ReplyDeleteAnswer, please?
ReplyDeleteIt's now posted online - just scroll down the web page.
DeleteThanks!
ReplyDelete