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Monthy Case Studies - 2001
Case #67 - September, 2001
A 67-year-old woman visited her health care provider because of a subcutaneous nodule located in the posterior area of her right shoulder. The cyst was surgically removed. It measured three to four centimeters in diameter and was filled with clear fluid. The material was submitted for histological examination. Sections were made and stained with H & E (hematoxylin and eosin). Figure A shows a large area of the stained section captured using 50× magnification (5× objective) from one slide, and Figures B and C show cropped areas using 200× magnification (20× objective). What is your diagnosis? Based on what criteria?
Figure A
Figure B
Figure C
Answer to Case #67
This was a case of coenurosis caused by the larval stage of a Taenia sp. The nodule removed from the patient was a coenurus. We speculated that the species in this case was T. serialis (formerly called Multiceps serialis), a tapeworm of canids. However, intact protoscoleces and measurements of the hooks and/or molecular methods would be necessary to confirm the diagnosis. Diagnostic features observed were:
- the size of this cyst, which was larger than the typical cysticercus cyst that are generally 5 to 15 mm in diameter when located in muscle tissue.
- the presence of multiple protoscoleces (cysticerci have only one protoscolex).
- the lack of a laminated outer layer of the cyst wall, which is present in hydatid cysts caused by Echinococcus spp.
Figure A
More on: Coenurosis
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.
