Giardia Is Often Overlooked on Histopathologic Examination: A High-Volume, Single-Institution Experience.
Int J Surg Pathol
; 29(3): 257-262, 2021 May.
Article
en En
| MEDLINE
| ID: mdl-32772760
ABSTRACT
AIMS. GIARDIA is sometimes missed by the pathologist, and we sought to determine how often this occurs at our institution-a large tertiary care center with a subspecialty gastrointestinal pathology service and what certain clinical and histologic clues can be used to flag cases with a higher likelihood of infection, targeting them for greater scrutiny. METHODS AND RESULTS:
We identified a set of patients who tested positive for Giardia with a stool-based test, and who also received a small bowel biopsy at a similar time-point. These biopsies were retrospectively reviewed for Giardia, finding 8 positive cases. The organism was prospectively detected in 4 cases (50%) but overlooked in the remaining 4 cases (50%). Three of the 4 cases missed cases showed only rare organisms. The detected cases tended to more frequently have prominent lymphoid aggregates (3 detected cases, 0 overlooked cases) and intraepithelial lymphocytosis (3 detected cases, 0 overlooked cases). Certain clinical and histologic clues can be used to flag cases with a higher likelihood of infection. Specifically, we found abnormalities of the mucosa (active inflammation, intraepithelial lymphocytosis, villous expansion, prominent lymphoid aggregates) in each case, and 4 of 8 cases were from immunocompromised patients. Finally, 2 of 8 cases were terminal ileum biopsies.CONCLUSIONS:
Biopsies with a histologic abnormality or those from immunocompromised patients should receive greater attention. Routinely looking for Giardia at that terminal ileum is necessary.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Giardiasis
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Duodeno
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Giardia
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Íleon
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Mucosa Intestinal
Tipo de estudio:
Observational_studies
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Prognostic_studies
Límite:
Adult
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Aged
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Child, preschool
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Int J Surg Pathol
Asunto de la revista:
PATOLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos