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A parasitologist's view of the world
Welcome to Parasite Case of the Week
Every week I will post a new Case, along with the answer to the previous case. Please feel free to write in with your answers, comments, and questions. Also check out my image archive website at http://parasitewonders.com. Enjoy!
The Fine Print:
Please note that all opinions expressed here are mine and not my employer. Information provided is for educational purposes only. It is not intended as and does not substitute for medical advice. I do not accept medical consults from patients.
The Fine Print:
Please note that all opinions expressed here are mine and not my employer. Information provided is for educational purposes only. It is not intended as and does not substitute for medical advice. I do not accept medical consults from patients.
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14 comments:
Hooklets from Echinococcus sp sand aspirated from a Hydatid cyst
Echinococcus sp from Hydatid cyst. Many hooklets.
Echinococcus
Arena hidatidica
Uncini di Echinococcus granulosus
Carlo Alberto Varlani
Rostellar hooklets of Echinococcus granulosus. Species E.granulosus is likely due to detection of hooklets in a liver cyst.
Hooklets most likely of E. granulosis giving the fact that it was aspirated from a liver cysts.
Florida Fan
Hydatid sand showing numerous hookless of echinococcus species
The larval cestodes having rostella with two rows of hooks (one row large hooks, one row small hooks} making this cestode "armed". An armed rostellum puts this worm into the family taeniidae.
The specimen appears to to contain a number of protoscolices in a liquid media from a single cyst. This would be consistent with the hydatid sand from an Echinococcus granulosis cyst.
A close relative which can also be found infecting the human liver, E. multilocularis contains far less liquid and much more debris from locular membranes. I have seen only one case of E. multilocularis and it was sterile (containing no protoscolices). I was told that most human cases are sterile. Please let me know if there is any truth to that statement.
There are other species of Echinococcus but I'm not familiar with their larval stages.
Therefore, my diagnosis is definitely Echinococcus, most likely E. granulosis
P.S. a size bar would be nice
P.P.S. I believe I once saw a movie made at the MAYO whose subject was the diagnosis and removal of E. cyst. Am I hallucinating ?
the old one
Yep, definitely hooklets of Echinococcus species! Most likely granulosus, as multilocularis usually produces sterile cysts. Some other species (like E. oligarthrus , E. vogeli, etc) can also sometimes infect humans.
I agree with Idzi and the Old One. Echinococcus, in the 'granulosus-complex' (I am sure Bobbi will address recent taxonomic issues with this complex in her answer). As previously mentioned, E. multilocularis usually manifests as a proliferating tumor in the liver that is 'sterile' (i.e., protoscoleces are not seen in the human host; they are seen in the liver of the natural rodent intermediate host however).
This form in aspirates where you have disintegrating protoscoleces with free hooklets and calcareous corpuscles is often referred to as 'hydatid sand'.
I agree, there are many hooklets, most likely from hydatid cyst Echinococcus granulosus as it was from liver cyst fluid
Hollywood trivia:
TV Dr. Marcus Welby diagnosed a case of hydatid disease in his son-in-law, an engineer who built dams in Latin American. The good Dr. performed surgery but lost his patient to anaphylactic shock.
To Old One - there were actually several videos of echinococcosis that came out of Mayo Clinic, including work by my predecessors, Dr. John Thompson and Dr. Thomas Magath, who both did research in this area (1940s-50s). They collaborated with Disney to produce a film on E. multilocularis, and later went on to do studies where dogs were orally-inoculated with hydatid cyst material (yuck!). It was quite the advance back in the days...
to Dr. Pritt,
Perhaps Dr. Welby (as well as his son-in-law)would've benefited greatly from a consult with Mayo Clinic.
I believe I've met Dr. Thompson, if I remember correctly his sense of humor had no equal. I heard jokes that I still cherish today.
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