Monday, January 27, 2020

Case of the Week 578

This week's case is from one of our former fellows, Dr. Rachael Liesman. The structures in question were seen in H&E-stained sections of small bowel.




Identification?

10 comments:

Sir Galahad said...


Kinorhynchus ?

Sir Galahad said...

Kinorhynchus, female with eggs

Anonymous said...

This case is "wild". Dr. Pritt has said in her email that this is an "incidental" finding, and as such I do believe that Sir Galahad comment is true.
Very bewildered Florida Fan.

Blaine A. Mathison said...

These are proglottids of a Hymenolepis species; probably H. nana but I cannot make out polar filaments (which can be visible in H&E stains). Note, however, that hooklets do not stain with H&E so they would not be visible in such a prep.

Note: Incidental finding does not necessarily mean the finding is not significant, it just means it not what they where initially looking for or suspecting.

Idzi P. said...

I agree with Blaine: looks like Hymenolepis.
I’d say H. nana, also based on the size of the eggs, which seem too small to be H. diminuta.
But I wouldn’t bet on it... Cut worm is really not my thing... ;-)
Nice case!!!

Old One said...

Agree with Blaine and Idzi

Old One said...

P.S. I believe I can see a few refractile hexacath hooklets in several of the eggs in photo three.

BUCK said...

I AM GOING FOR THE LONG SHOT HERE - Oh I so love this profession..... .. Echinococcus granulosus hydatid cyst - NOTABLY enlarging the UPPER RIGHT CORNER IMAGE AND image that is right of center Echinococcus granulosus hydatid cyst with rostellum - with scolices within a daughter cyst and rostellar hooks of one of the scolices. I wish I could provide side by side comparisons using industry standard as comparison - Since the access does not allow side by side comparison.

Blaine A. Mathison said...

yes, Old One. Hooklets can be visible as refractile bodies (they just don't take up H&E stain)

Anonymous said...

The craspedote proglottids do agree with Blaine's identification. I could not visualize the hooklets. Just like Idzi, "cut worm" is my Achilles tendon.
Florida Fan