Case #505 – December, 2019
A male patient originally from Afghanistan, who had moved to the United States a few months ago, required medical attention for a lesion on his hand. It first appeared about one year prior but had recently grown considerably. The patient is otherwise asymptomatic, and the lesion has no pruritus, pain, or discharge. A biopsy of the lesion was obtained, and the pathology laboratory reported lymphohistiocytic infiltrates. A portion of the unpreserved biopsy was sent in a universal transport medium to the CDC for further testing. A touch prep was made and stained with Giemsa. Figures A and B show what was observed at 1000x oil immersion magnification. The objects of interest measure 2.5 – 3.5 micrometers on average.
What is your diagnosis? Based on what criteria? What, if any, other tests would be necessary for this case?
Figure A
Figure B
Images presented in the dpdx case studies are from specimens submitted for diagnosis or archiving. On rare occasions, clinical histories given may be partly fictitious.