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Monthy Case Studies - 2012

Case #326 - June, 2012

A 65-year-old female, who lives in northern California, had a colonoscopy performed as part of a routine screening. A foreign body was observed and subsequently removed. The specimen was sectioned, stained with hematoxylin and eosin (H&E), and examined by the attending pathologist. Digital images were captured and sent to the DPDx Team for diagnostic assistance. Figure A was captured at 2x; Figure B at 20x; and Figures C and D at 40x magnification. What is your diagnosis? Based on what criteria?

Figure A

Figure A

Figure B

Figure B

Figure C

Figure C

Figure D

Figure D

Acknowledgments: This case and images were kindly provided by Miraca Life Sciences, Phoenix, Arizona.

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Answer to Case #326

This was a case of trichuriasis (commonly called whipworm) caused by the nematode Trichuris trichiura. Morphologic diagnostic features shown included:

  • a thick, annulated cuticle.
  • a nucleated hypodermis (HY, Figure C) and somatic muscle cells (SM, Figure C).
  • a bacillary band (BB, Figure D).
  • barrel-shaped eggs with polar plugs (best seen in Figure C).
Figure C

Figure C

Figure D

Figure D

More on: Trichuriasis

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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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