Abdominal Angiostrongyliasis: A Presentation of Eosinophilic Granulomatous Colitis.
Timothy WallsDominick CavuotiNandini ChannabasappaMary YangPaul SouthernMichelle A GillJason Y ParkPublished in: International journal of surgical pathology (2017)
We present a case of a 4-year-old girl with abdominal angiostrongyliasis who presented with persistent fevers, hepatosplenomegaly, acute abdominal pain, and eosinophilia. Computed tomography scan identified thickening of the ascending colon with a narrowed lumen. Endoscopic evaluation revealed ulcerations and erythema in the ascending colon. The microscopic findings in biopsies included active chronic inflammation with prominent eosinophils and granulomas. A subset of granulomas contained the eggs of Angiostrongylus costaricensis. The definitive method of diagnosing A costaricensis is histology; peripheral blood serology has low specificity and the stool from infected patients does not contain eggs or larvae. Pathologists from endemic regions (Central and South America) are familiar with the typical histologic changes; however, because of increasing global travel, all pathologists should become familiar with A costaricensis, which may mimic common gastrointestinal diseases such as Crohn's disease, appendicitis, and Meckel's diverticulum.
Keyphrases
- computed tomography
- abdominal pain
- ultrasound guided
- peripheral blood
- aortic dissection
- pulmonary artery
- liver failure
- positron emission tomography
- oxidative stress
- drug induced
- magnetic resonance imaging
- respiratory failure
- dual energy
- single cell
- contrast enhanced
- interstitial lung disease
- aedes aegypti
- pulmonary hypertension
- image quality
- case report
- coronary artery
- rheumatoid arthritis
- radiation therapy
- chronic rhinosinusitis
- structural basis
- locally advanced
- ulcerative colitis
- pulmonary arterial hypertension
- acute respiratory distress syndrome
- squamous cell carcinoma
- infectious diseases
- idiopathic pulmonary fibrosis