Case #516 – May, 2020
A 58 year-old-man from Peru visiting relatives in the United States was killed in a traffic accident. An autopsy revealed cysts in his liver of which a few were excised and sent to pathology for identification. Figures A–C, taken at 40x, 100x, and 200x respectively, show what was observed on a histologic section of a cysts stained with hematoxylin and eosin (H & E). What is your diagnosis? Based on what criteria?
Figure A
Figure B
Figure C
The deceased in this case had cystic echinococcosis (hydatid disease) caused by the larval stages of cestodes of the Echinococcus granulosus complex. Diagnostic morphologic features presented in this case included:
- host tissue (Figure A – black arrow) encapsulating the acellular hydatid cyst wall (Figure A – blue arrow)
- multiple protoscolices within the cyst with hooklets visible in some (Figure C – black arrows)
 Figure A |
 Figure C |
More on echinococcosis
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.