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:

  1. 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.

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  2. 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.

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  3. 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!!!

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

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  5. 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.

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

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  7. 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

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