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Monthy Case Studies - 2012

Case #324 - May, 2012

A 58-year-old female who had emigrated from Africa was seen by her health care provider for complications with squamous cell carcinoma of the cervix. CT scans of the pelvis revealed a small mass in the bladder. Biopsy specimens of the bladder and subsequent bladder washings were sent to Pathology for histological work-up. Microscopic examination of the specimens by the attending pathologist revealed structures suggestive of a parasite. Digital images were sent to the DPDx Team for diagnostic assistance. Figures A-D show what was observed in the biopsy specimens, stained with hematoxylin and eosin (H&E). Figures E and F show what was observed in the bladder washings, stained with Papanicolaou stain. The object in Figure E measured 150 micrometers in length. What is your diagnosis? Based on what criteria?

Figure A

Figure A

Figure B

Figure B

Figure C

Figure C

Figure D

Figure D

Figure E

Figure E

Figure F

Figure F

Acknowledgements: This case and images were kindly provided by the John H. Stroger Jr. Hospital of Cook County, Chicago, IL.

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Answer to Case #324

This was a case of schistosomiasis caused by Schistosoma haematobium. Morphologic diagnostic features included:

  • presence of eggs in bladder tissue (Figures A-D).
  • elongated, non-operculated eggs bearing a terminal spine and within the size range for S. haematobium (Figure E).
  • eggs containing defined miracidia (best seen in the biopsy sections in Figures B-D).
  • free ciliated miracidium (Figure F).

More on: Schistosomiasis

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Images presented in the monthly case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.

 
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  • Page last reviewed November 29, 2013
  • Page last updated November 29, 2013
  • Content source: Global Health - Division of Parasitic Diseases and Malaria
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