Is this parasite? Or vegetable materials?
If this is a kind of parasite, which one would it be?
all H&E stains, the last one is PAS stain
The diameter of this foreign material is about 1 mm
The patient had a recent travel history to Japan.
He had no peripheral eosinophilia.
There was not so many eosinophils around this material but some plasma cells.
There was an ill-defined fistulous track around this lesion.
However, the possibility of diverticulitis could not be completely ruled out.
What is your diagnosis?
Dear Yosep,
do you have more images and more details (size of the object)? To me it looks like a worm, possibly whipworm (Trichuris) as one side seems to be thinner but I don't see it clearly so I might be wrong. around the object is visible cell infiltration, probably eosinophils but bigger magnification would be more helpful.
Dear Yosep,
i think things that Jaroslaw, but I like know the host specie.
Can't see clearly (my computer doesn't want to enlarge the image sufficiently). Also, there is no scale to go by. Particularly if it is a section, there is something vaguely reminiscent, shape-wise, of the helminth Enterobius vermicularis as seen in section in the appendix, where it can be found. However, I don't know what I'm looking at in terms of the nature of the specimen, so it is unclear whether or not this is Enterobius (either cut or not).
P.S.: Further to my previous posting, this looks like an H & E - stained section. Detail isn't clear in the image, but Enterobius must, nevertheless, definitely come into the differential diagnosis.
Although it is not very clear but itit seems to be belonging to whipworm
Is this a cross-section of the appendix? There seem to be stichosomes (stichosoma) along one part of it, probably from a whip worm ( Trichuris trichiura).
The additional images that have been added are helpful. The Trichuris-like outline is apparent, but what is going on here needs further consideration. Claudia's comment is interesting.
I am intrigued with the tegument and the projections that are clearly visible. I do know that schistosomes sometime affect the appendix. But the section really doent show much detail of the internalia of the parasite...?
I wondered as well why we cannot see some internalia, parts of tissue, cell, anything. It looks like a worm, I thought it might me a crossection of Schistosome too but I think it is very hard to identify this specimen. For trichuris, the size is too small, older individuals (30mm) tend to migrate near appendix but the diameter of this specimen is 1mm
A reference I have found very useful for similar cases, but unfortunately not in this case is:
Maybelle Chitwood & J Ralph Lichtenfels, 1972. Parasitological Review. Identification of parasitic metazoa in tissue sections. Experimental Parasitology 32, 407-519.
Yes, had obvious helminth-type internal structural details been visible, there would have something to go on. In addition to the publication you mention, Paul, I can think of 2 more offhand. Very useful for when helminths are encountered in tissue.
sorry for my late reply ;) Just reading now by hazard Your question.
I am pretty sure that it was a tomato peel! I found a similar case with better conserved matherial
https://journals.sagepub.com/doi/10.1177/1066896919833168?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
Very interesting comment. A plant anatomist needs to have a look at the images!
Always worth to nurture lateral passions! I am italian and during my specialisation saw so many Times that image... one day in a speciman a found a perfectly intact And recognizeble peel Of tomato and had The idea to embed it. this is why i am sure of what those Yellow serrated strands are!
Surprising answer!
It would be best if you can also share any of the examples you experienced.
Actually with the University group of Genova we have published a couple of articles on this matter, and a third one is under submission. If you would have time to have a look at the images inArticle The Seeds of Doubt: Finding Seeds in Intriguing Places
andArticle Seeds in the appendix: A 'fruitful' exploration
please let me know if You ever find something similar in Your routinary work!
It would seem that Yosep Chong was correct in raising the matter of possible plant material in the original question.
Michela Campora, yellow is the new black!
Yellow Is the New Black - Michela Campora, Laura Cornara, Michele Paudice, Luca Mastracci, Federica Grillo, 2019 (sagepub.com)
This is a short case report (image in pathology) showing exactly the image Yosep has proposed. :)
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