Case 12

Clinical history

41 year old man, watery diarrhea and abdominal pain.

Site

Colon biopsy.

Primary image

Intermediate magnification. H&E stain.

Expand High magnification
High magnification. H&E stain.

Expand Very high magnification
Very high magnification. H&E stain.

Differential diagnosis

Expand Differential diagnosis
normal colon, cryptosporidiosis, CMV colitis, compatible with infectious diarrhea, ischemic colitis

Additional tests

More history

Expand More history
No family history of IBD. Diarrhea several weeks. Well prior to diarrhea. Medications: one anti-hypertensive.

Ask a friend

Expand Ask a friend
Did you see anything at high magnification?

Stains

ExpandAlcian blue/PAS to Bilirubin Test Result Alcian blue/PAS Expand Dr Torres would ask why! Alican blue pH 1.0 Expand Dr Torres would ask why! Alcian blue pH 2.5 Expand Dr Torres would ask why! Auramine Expand Dr Torres would ask why! Bielchowsky Expand Dr Torres would ask why! Bilirubin Expand Dr Torres would ask why!	ExpandColloidal iron to Fontana-Masson Test Result Colloidal iron Expand Dr Torres would ask why! Congo red Expand Dr Torres would ask why! Cresyl violet Expand Dr Torres would ask why! Dieterle Expand Dr Torres would ask why! Diff Quik Expand Dr Torres would ask why! Fontana-Masson Expand Dr Torres would ask why!	ExpandGallyas to Gremelius Test Result Gallyas Expand Dr Torres would ask why! Giemsa Expand Dr Torres would ask why! GMS Expand Dr Torres would ask why! Gomori's trichrome Expand Dr Torres would ask why! Gram Expand Dr Torres would ask why! Gremelius Expand Dr Torres would ask why!	ExpandJMS to Mucicarmine Test Result JMS Expand Dr Torres would ask why! Jones Expand Dr Torres would ask why! Kinyoun Expand Dr Torres would ask why! Luxol fast blue Expand Dr Torres would ask why! Masson trichrome Expand Dr Torres would ask why! M-MAS Expand Dr Torres would ask why! Movat Expand Dr Torres would ask why! Mucicarmine Expand Dr Torres would ask why!	ExpandOil red O to Prussian blue Test Result Oil red O Expand Dr Torres would ask why! Orecein Expand Dr Torres would ask why! PAS Expand Dr Torres would ask why! PASD Expand Dr Torres would ask why! PASF Expand Dr Torres would ask why! PTAH Expand Dr Torres would ask why! Prussian blue Expand Dr Torres would ask why!	ExpandReticulin to Ziehl-Neelsen Test Result Reticulin Expand Dr Torres would ask why! Sudan black B Expand Dr Torres would ask why! Toluidine blue Expand Dr Torres would ask why! Verhoeff Expand Dr Torres would ask why! Von Kossa Expand Dr Torres would ask why! Warthin-Starry Expand Spirochetes Ziehl-Neeslen Expand Dr Torres would ask why!

IHC

ExpandAlpha-1 AT to Cathepsin K Test Result alpha-1 AT Expand Dr T would ask why! ACTH Expand Dr T would ask why! AE1/AE1 Expand Dr T would ask why! alpha-fetoprotein Expand Dr T would ask why! Alk-I Expand Dr T would ask why! AMACR Expand Dr T would ask why! AR Expand Dr T would ask why! ATRX Expand Dr T would ask why! Beta2-microglobulin Expand Dr T would ask why! B72.3 Expand Dr T would ask why! Beta-catenin Expand Dr T would ask why! BCL2 Expand Dr T would ask why! BCL6 Expand Dr T would ask why! BCLxL Expand Dr T would ask why! C3 comp Expand Dr T would ask why! CA9 Expand Dr T would ask why! Calcitonin Expand Dr T would ask why! Calponin Expand Dr T would ask why! Calretinin Expand Dr T would ask why! CAM5.2 Expand Dr T would ask why! Cathepsin K Expand Dr T would ask why!	ExpandCD10 to Chromogranin Test Result CD10 Expand Dr T would ask why! CD117 Expand Dr T would ask why! CD138 Expand Dr T would ask why! CD15 Expand Dr T would ask why! CD1a Expand Dr T would ask why! CD20 Expand Dr T would ask why! CD21 Expand Dr T would ask why! CD23 Expand Dr T would ask why! CD3 Expand Dr T would ask why! CD30 Expand Dr T would ask why! CD31 Expand Dr T would ask why! CD34 Expand Dr T would ask why! CD35 Expand Dr T would ask why! CD4 Expand Dr T would ask why! CD43 Expand Dr T would ask why! CD45 (LCA) Expand Dr T would ask why! CD5 Expand Dr T would ask why! CD56 Expand Dr T would ask why! CD57 Expand Dr T would ask why! CD68 Expand Dr T would ask why! CD7 Expand Dr T would ask why! CD79a Expand Dr T would ask why! CD8 Expand Dr T would ask why! CD99 Expand Dr T would ask why! CDX2 Expand Dr T would ask why! CEA-m Expand Dr T would ask why! Chromogranin Expand Dr T would ask why!	ExpandCK17 to Glypican 3 Test Result CK17 Expand Dr T would ask why! CK19 Expand Dr T would ask why! CK20 Expand Dr T would ask why! CK34betaE12 Expand Dr T would ask why! CK5/6 Expand Dr T would ask why! CK7 Expand Dr T would ask why! CMV Expand Dr T would ask why! c-MYC Expand Dr T would ask why! Cyclin D1 Expand Dr T would ask why! D2-40 Expand Dr T would ask why! Desmin Expand Dr T would ask why! DOG1 Expand Dr T would ask why! EBV Expand Dr T would ask why! EMA Expand Dr T would ask why! ER and PR Expand Dr T would ask why! Factor VIII Expand Dr T would ask why! Factor XIIIa Expand Dr T would ask why! Fascin Expand Dr T would ask why! FH Expand Dr T would ask why! FSH Expand Dr T would ask why! Gastrin Expand Dr T would ask why! GATA3 Expand Dr T would ask why! GCDFP-15 (BRST2) Expand Dr T would ask why! GFAP Expand Dr T would ask why! GH Expand Dr T would ask why! Glucagon Expand Dr T would ask why! Glypican-3 Expand Dr T would ask why!	ExpandHBME-1 to IgM Test Result HBME-1 Expand Dr T would ask why! HBV core Expand Dr T would ask why! HBV surface Expand Dr T would ask why! H-caldesmon Expand Dr T would ask why! HCG Expand Dr T would ask why! Helicobacter Expand Dr T would ask why! Hepatocyte Expand Dr T would ask why! HER2/neu Expand Dr T would ask why! HHV-8 Expand Dr T would ask why! HMB-45 Expand Dr T would ask why! HNF1beta Expand Dr T would ask why! HPV Expand Dr T would ask why! HSV-I Expand Dr T would ask why! HSV-II Expand Dr T would ask why! IDH-1 Expand Dr T would ask why! Inhibin Expand Dr T would ask why! INI1 (BAF47) Expand Dr T would ask why! Insulin Expand Dr T would ask why! Kappa Expand Dr T would ask why! Ki-67 Expand Dr T would ask why! Lambda Expand Dr T would ask why! Leu 7 Expand Dr T would ask why! IgA Expand Dr T would ask why! IgG Expand Dr T would ask why! IgM Expand Dr T would ask why!	ExpandLH to PDGFR Test Result LH Expand Dr T would ask why! LIN28 Expand Dr T would ask why! Lysozyme Expand Dr T would ask why! mammoglobin Expand Dr T would ask why! MAP2 Expand Dr T would ask why! MCV Expand Dr T would ask why! Melanin A Expand Dr T would ask why! MHC class I Expand Dr T would ask why! MITF Expand Dr T would ask why! MUM1 Expand Dr T would ask why! Myeloperoxidase Expand Dr T would ask why! MYO D1 Expand Dr T would ask why! Myoglobin Expand Dr T would ask why! Napsin Expand Dr T would ask why! NF Expand Dr T would ask why! NKX3.1 Expand Dr T would ask why! NSE Expand Dr T would ask why! OCT3/4 Expand Dr T would ask why! p16 Expand Dr T would ask why! P501S Expand Dr T would ask why! p53 Expand Dr T would ask why! p57 Expand Dr T would ask why! p63 Expand Dr T would ask why! Pankeratin Expand Dr T would ask why! PAX2 Expand Dr T would ask why! PAX5 Expand Dr T would ask why! PAX8 Expand Dr T would ask why! PCNA Expand Dr T would ask why! PDGFR Expand Dr T would ask why!	ExpandPLAP to WT1 Test Result PLAP Expand Dr T would ask why! PNL-2C Expand Dr T would ask why! Prolactin Expand Dr T would ask why! PSA Expand Dr T would ask why! PSAP Expand Dr T would ask why! RCC Expand Dr T would ask why! S-100 Expand Dr T would ask why! SALL4 Expand Dr T would ask why! Smooth muscle actin Expand Dr T would ask why! Somatostatin Expand Dr T would ask why! STAT6 Expand Dr T would ask why! Synaptophysin Expand Dr T would ask why! TdT Expand Dr T would ask why! TFE3 Expand Dr T would ask why! TFEB Expand Dr T would ask why! Thyroglobulin Expand Dr T would ask why! Toxoplasma Expand Dr T would ask why! TSH Expand Dr T would ask why! TTF-1 Expand Dr T would ask why! Ubiquitin Expand Dr T would ask why! UCHL1 (PGP9.5) Expand Dr T would ask why! Ulex Europaeus Expand Dr T would ask why! Vimentin Expand Dr T would ask why! VIP Expand Dr T would ask why! VZV Expand Dr T would ask why! WT-1 Expand Dr T would ask why!

Diagnosis

Expand Diagnosis
Intestinal spirochetosis.