Monday, October 2, 2017

Case of the Week 462

This week I am introducing an exciting new collaboration with Idzi Potters and the Institute of Tropical Medicine Antwerp. This renowned institution has provided health care and research in the field of tropical infectious diseases for more than a century and has accumulated a wealth of marvelous instructive cases. We will share a case from their archives on the first Monday of each Month.

This month's case is of a 60 year-old Belgian woman with a long history of travel to sub-Saharan Africa. She presented with persistent upper abdominal discomfort and radiologic imaging revealed a large liver cyst. Below are representative photographs (shown at 200X to 400X original magnification) and a video clip of the unstained aspirated material. Identification?





See the fascinating motility of one of these objects:



10 comments:

Anonymous said...

Echinococcus granulosus, causing a hydatid cyst of the liver. A protoscolex and several hooklets are seen.

Carlo Alberto Varlani said...

Protoscolici ed uncini di Echinococcus granulosus.

Anonymous said...

What a beautiful case. The photography is superb. Typical hydatid cyst containing protoscoleces and booklets.
Florida Fan

Sheldon Campbell said...

What everyone else said, but the video is simply...astonishing.

Anonymous said...

Great pictures of the hydatid cyst of Echinococcus granulosus! Protoscolex, free hooklets in "hydatid sand"..., by the way, are the rounded structures of photos 4 and 5 calcareous corpuscles?
Dr. Pritt what great news the collaboration of the prestigious ITM...

Sugar Magnolia said...

I concur. What more can I say that hasn't already been stated? Echinococcus granulosus infection, resulting in hydatid cyst of the liver. The protoscolex and hooklets are characteristic of E. granulosus and are presented in such beautiful detail here that I can't help but keep coming back to view the photos and video. What a treat! I learn so much each time I view these case studies, and now with the addition of presentations from the Institute of Tropical Medicine, I can scarcely wait to see what I will learn next week! Thank you for an outstanding blog, Bobbi!

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Gianna Tansarli said...

Echinicoccus granulosus with its typical hooklets. I have seen E.granulosus only two times until now, in a laboratory of a tertiary care hospital in Athens, Greece.Thank you for the educational cases.

Idzi P. said...

Many thanks for the very nice comments everybody!
The rounded structures are indeed calcareous corpuscles. No comments on the first photo? It's rather typical too, but rarely seen!

Anonymous said...

Yes, Idzi. Many thanks for pointing that out to us. As stated in our book, the outer cyst epidermis is multi layered and anucleated.The inner layer is the germinal epithelium.
Florida Fan