Thanks to the readers who responded with the correct diagnosis to last week’s case! I’ve also presented this case at our weekly clinical pathology conference and I’ve found it extremely interesting and educational. This was indeed a case of hepatosplenic T-cell lymphoma (HSTL), gamma-delta type. Characteristically, lymphadenopathy was absent and there was no peripheral involvement [...]
It’s been a while since I posted an interesting case, but here’s one that I saw in follow-up during my flow cytometry month. The patient is a 44 yo M with a history of end-stage renal disease secondary to hypertensive nephropathy who was awaiting transplant > 2 years and undergoing peritoneal dialysis. Fatigue and anemia [...]
The following was ‘passed’ in the stool of an otherwise asymptomatic 50 year old woman. (images courtesy of Dr. Washington Winn, Fletcher Allen Health Care, VT) Identification?
Answer: Rhinosporidiosis (infection with Rhinosporidium seeberi) Congratulations to Anonymous (x 3!), Kenneth, Chris, Victor, and Santoshpath who all got this correct! The keys to the diagnosis is the clinical history (location in nasal mucosa), exposure history (India), and histopathologic features of a polypoid mass containing mature sporangia (large, thick-walled spherical structures) and smaller internal sporangiospores [...]
Here’s a challenge for all of you: Nasal polyp removed from a 50 year old Indian man with complaints of chronic nasal obstruction. Histologic exam reveals the following:
Answer: Trypomastigotes and intermediate trypomastigote/amastigote forms of Trypanosoma cruzi. Thanks to everyone who wrote in for this case! This was, admittedly, a tricky case, since it is uncommon to see amastigote-type forms in peripheral blood. The reason these atypical forms were present is because this specimen was grown in culture and then innoculated in peripheral [...]
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