This week's case is from a middle-aged woman with unexplained small bowel perforation. Here is the section with the culprit. You can view the whole slide image HERE. What is your diagnosis?
In this magnificent section we can clearly see features consistent with an anisakid infection: multilayered cuticle (from a portion which seems detached, in the upper part), polymyarian muscle cells, the beautiful Y shaped lateral chords and the banana-shaped excretory cell.
From the quite slender appearance of the lateral cords I think we could suppose this is actually Anisakis spp, but a definitive identification would require the observation of other characteristics like the caecum position and shape, or molecular diagnostics strategies.
The culprit is SUSHI!
ReplyDeleteIn this magnificent section we can clearly see features consistent with an anisakid infection: multilayered cuticle (from a portion which seems detached, in the upper part), polymyarian muscle cells, the beautiful Y shaped lateral chords and the banana-shaped excretory cell.
From the quite slender appearance of the lateral cords I think we could suppose this is actually Anisakis spp, but a definitive identification would require the observation of other characteristics like the caecum position and shape, or molecular diagnostics strategies.
Luca Fanasca, MD
Thank you Dr. Fanasca for the answer to that which kept my brain twisting and turning.
ReplyDeleteFlorida Fan
Agree with Luca. A case of anisakiasis.
ReplyDelete