Case #278 – June, 2010

DPDx is moving! Along with the all of the laboratories within the Division of Parasitic Diseases and Malaria at the CDC! We want to take this opportunity to let you know that although actual specimen receiving and testing will be temporarily interrupted for about a week or two, DPDx will continue to provide telediagnosis assistance via the internet.

This leads us to the second case for this month. While packing for the move, we discovered an interesting pathology slide labeled with only an accession number. Figure A shows the slide and Figure B shows the specimen using a dissecting microscope. The slide was observed under a compound microscope for higher magnification; Figures C and E show areas captured at 40x, and Figures D and F at 200x. What is your diagnosis? Based on what criteria?

Figure A

Figure B

Figure C

Figure D

Figure E

Figure F

The slide showed a case of coenurosis which is caused by infection with the metacestode larval stage (coenurus) of Taenia multiceps or T. serialis. The presence of protoscoleces ruled-out sparganosis (caused by Spirometra spp.). The presence of more than one protoscolex within the cyst ruled-out cysticercosis (caused by Taenia solium). The thin cyst wall lacking a laminated layer ruled-out echinococcosis (caused by Echinococcus sp.). Coenuri may be found in most tissue types, but those of T. multiceps have a predilection for the central nervous system and eye; those of T. serialis are usually found in subcutaneous tissue.