Clinical history: A 61 year old male with a history of multiple myeloma presented to hospital with abdominal pain and gastrointestinal bleeding. Upper and lower endoscopy was performed.
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Discussion and answer
Sections show small fragments of core biopsy tissue infiltrated by adenocarcinoma. The neoplasm is predominantly located in submucosa.
Biopsies taken from the duodenum show an inflammatory infiltrate in the lamina propria and epithelium, consisting of plasma cells, lymphoctyes, neutrophils, and eosinophils. Several parasites are seen embedded in the mucosal crypts and inside the epithelium. On cross section, the organisms’ intestine and paired ovaries are visible. The parasites measure approximately 20-35 microns across. Several eggs are also observed. These features are consistent with a Strongyloidiasis infection.