Residency Program - Case of the Month

Clinical history:

The patient is a 30 year-old-female from Sudan with no significant past medical history who presents with an incidental finding of persistent mildly elevated liver function tests and microcytic anemia. She denies alcohol and acetaminophen use.  She is negative for HIV, hepatitis C and hepatitis B. An abdominal ultrasound shows an enlarged liver to 11cm with portal vein dilation. Esophagogastroduodenoscopy (EGD) showed diffuse flattening of the duodenal villi. The colonoscopy showed diffuse nodularity throughout the colon and with two polyps (3mm & 2mm) in the cecum. These two polyps were biopsied and submitted for pathologic interpretation.  Internal hemorrhoids were also noted.

EGD:

Colonoscopy:

Figure 2. cecum, nodular mucosa			Figure 3. TI, featureless muscosa.

Microscopic Photographs:

Stool Ova and Parasite Wet Mount:

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