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An inflamed appendix was removed surgically and sent to Surgical Pathology. When it was cut open, approximately 15 of the following objects were found inside the lumen:
Well, this was definitely a challenging case this week! Many of you wrote in with suggestions that this is some type of fly larvae, and that is certainly a good thought. However, there are no structures such as spines or mouth parts to confirm this identity, and the history would be a bit odd.
Instead, [...]
I recently did a brain autopsy on a 70-year-old woman who died from an intraparenchymal brain hemorrhage after a seven-year history of progressive dementia. The gross photograph follows:
I know what you’re thinking: an amyloid angiopathic bleed, or perhaps a hypertensive bleed, in a patient with Alzheimer disease. That’s what I was thinking until I saw [...]
High Grade Prostatic Intraepithelial Neoplasia (HGPIN):
Common questions asked about HGPIN are :
-How do we as pathologists make these diagnoses?
-What do they mean for the patient in terms of cancer risk?
-What is/are the optimal strategies for follow-up so that if cancer does eventually develop it is caught at an early, curable stage?
These questions are shortly discussed [...]
The following object was found in the diaper of a 1 year old female. The mother noted that it was moving when found. Identification?
Answer: Schistosoma mansoni eggs
This case seemed to generate a lot of enthusiasm from the audience. Thank you all for the great comments! The eggs shown here are classic for S. mansoni, with their large size (>150 microns largest dimension) and classic lateral spine.
Chris C. asked how I thought to do the squash preparation on [...]
The follow are images of an unstained intestinal biopsy that was “squashed” between 2 slides. Please identify the objects present. They measure approximately 180 microns in greatest dimension.
Answer: Dirofilaria immitis; the Dog Heartworm
Congratulations to everyone who wrote in with the correct answer to this case!
Dirofilaria spp. cause both subcutaneous and pulmonary infections in humans, with D. immitis being largely responsible for the pulmonary infections in the U.S. and worldwide. In dogs, the adult worms live in the right side of the [...]
Here is a special case in honor of Valentine’s day. The following section of lung was removed due to the presence of a nodule that mimicked a lung carcinoma. However, on sectioning and H&E staining, the following was seen. Identification?
Answer: Pinworm (Enterobius vermicularis eggs).
A few of you noticed that I gave the answer away on the close up image! Thanks for writing in to let me know and share your thoughts.
As you all probably know, this is an extremely rare presentation of pinworm infection. Typically, deposition of eggs by the female work in [...]
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