Monday, October 2, 2017

Case of the Week 462

This week I am introducing an exciting new collaboration with Idzi Potters and the Institute of Tropical Medicine Antwerp. This renowned institution has provided health care and research in the field of tropical infectious diseases for more than a century and has accumulated a wealth of marvelous instructive cases. We will share a case from their archives on the first Monday of each Month.

This month's case is of a 60 year-old Belgian woman with a long history of travel to sub-Saharan Africa. She presented with persistent upper abdominal discomfort and radiologic imaging revealed a large liver cyst. Below are representative photographs (shown at 200X to 400X original magnification) and a video clip of the unstained aspirated material. Identification?





See the fascinating motility of one of these objects:



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12 comments:

  1. AnonymousOctober 2, 2017 at 10:47 AM

    Echinococcus granulosus, causing a hydatid cyst of the liver. A protoscolex and several hooklets are seen.

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  2. Carlo Alberto VarlaniOctober 2, 2017 at 10:59 AM

    Protoscolici ed uncini di Echinococcus granulosus.

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  3. AnonymousOctober 2, 2017 at 1:02 PM

    What a beautiful case. The photography is superb. Typical hydatid cyst containing protoscoleces and booklets.
    Florida Fan

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  4. Sheldon CampbellOctober 2, 2017 at 1:35 PM

    What everyone else said, but the video is simply...astonishing.

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  5. AnonymousOctober 2, 2017 at 2:34 PM

    Great pictures of the hydatid cyst of Echinococcus granulosus! Protoscolex, free hooklets in "hydatid sand"..., by the way, are the rounded structures of photos 4 and 5 calcareous corpuscles?
    Dr. Pritt what great news the collaboration of the prestigious ITM...

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  6. Sugar MagnoliaOctober 4, 2017 at 9:49 AM

    I concur. What more can I say that hasn't already been stated? Echinococcus granulosus infection, resulting in hydatid cyst of the liver. The protoscolex and hooklets are characteristic of E. granulosus and are presented in such beautiful detail here that I can't help but keep coming back to view the photos and video. What a treat! I learn so much each time I view these case studies, and now with the addition of presentations from the Institute of Tropical Medicine, I can scarcely wait to see what I will learn next week! Thank you for an outstanding blog, Bobbi!

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  7. AnonymousOctober 4, 2017 at 12:03 PM

    This comment has been removed by the author.

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  8. Gianna TansarliOctober 4, 2017 at 12:05 PM

    Echinicoccus granulosus with its typical hooklets. I have seen E.granulosus only two times until now, in a laboratory of a tertiary care hospital in Athens, Greece.Thank you for the educational cases.

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  9. Idzi P.October 4, 2017 at 12:39 PM

    Many thanks for the very nice comments everybody!
    The rounded structures are indeed calcareous corpuscles. No comments on the first photo? It's rather typical too, but rarely seen!

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  10. AnonymousOctober 5, 2017 at 10:09 AM

    Hello there! This article could not be written any better!
    Going through this post reminds me of my previous
    roommate! He continually kept talking about this.
    I most certainly will forward this article to him. Pretty sure he will have a very good read.
    I appreciate you for sharing!

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  11. AnonymousOctober 5, 2017 at 10:19 AM

    Yes, Idzi. Many thanks for pointing that out to us. As stated in our book, the outer cyst epidermis is multi layered and anucleated.The inner layer is the germinal epithelium.
    Florida Fan

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  12. Stefaan KurversOctober 15, 2017 at 12:29 AM

    Very nice pictures of Echinococcus granulosus. Earlier this year we had a patient with a lungcyst. Great to see as a labtechnician.

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