Tuesday, April 5, 2022

Case of the Week 678

This week's fascinating and unusual case was donated by Dr. Vicki Schnadig at University of Texas Medical Branch. The patient is an elderly woman from rural Louisiana who presented with a subcutaneous thigh nodule. Dr. Schnadig's team first performed a fine needle aspirate of the lesion which showed the following laminated spherical structure, but no definitive pathogen:

Following this, the team noted a worm-like object protruding from the aspiration site and pulled it out:

The following are histologic sections of this object:



Francisco Bravo MD said...

Sparganosis, the larvarial stage of Spirometra sp.s

Anonymous said...

Thank you Dr. Bravo, I followed your lead and see the numerous calcarous corpuscles and the eggs. The ribbon like body and enlarged head fits the parasite. The patient must have been a victim of a bad harvest of crawfish.
Florida Fan

Anonymous said...

After more studies I believe seeing the very thick tegument as well as the longitudinal smooth muscle.
Thank you Dr. Pritt for the tough yet very educational case.
Florida Fan