This week's beautiful case was donated by Drs. Beal, Saulino and Herrera Rivera from the University of Florida. The following structure was noted on a liver biopsy from a patient with former international residence. What is the diagnosis? Can you describe the key diagnostic features?
9 comments:
Just from the general morphology, the location in the body all point to a liver fluke, possibly Fasciola hepatica.The front is on the left upper side. For sure a cut up fluke never gives us all the anatomical details that we expect to see in a Carmine stain and as such I would depend on Dr. Pritt to give us a lecture on this aspect.
Florida Fan
Schistosoma egg in H&E stain.
When the eggs are deposited by the female worm in the arterial plexus of intestines/bladder, many of these eggs will flow back to the liver. In the picture, I can’t see the egg’s spine, so the exact species remains unknown, but we can see the refractive egg shell with miracidium inside. At the miracidium’s terebratorium (lower right) we can see one of the two lateral secretory glands (staining eosinophilic). Right behind this gland, we see a ring of nerve cells (surrounding the cephalic gland), creating the typical “bulls-eye” aspect. The dark staining round structures everywhere would be germ cells.
To Idzi : Idzi, I trust that you are right. In Parasitology “SIZE MATTERS”.
Florida Fan
Hi Florida Fan!
You *trust* I’m right…
I *hope* I’m right… 😅
I’m sure Dr. Pritt will tell us by the end of the week!
In the meantime: let’s see what others think of this one…?
Nice case with a beautiful and well-taken picture for sure!
I'll just say this, the abundance of eosinophils certainly points to a helminth egg granuloma. I'll leave it to those wiser than I
to opine
on the presence
or absence
of a spine
Eosinophils and the miracidium-like morphology point to granuloma caused by schistosome eggs. LOoking forward to
Schistosoma egg makes sense to me.
I like your poetic style!
Must be a schistosoma egg...
Bangladeshi Fan
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