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dc.contributor.authorRose, G.S.
dc.contributor.authorArnold, C.A.
dc.contributor.authorBadizadegan, K.
dc.date.accessioned2019-10-03T14:14:46Z
dc.date.available2019-10-03T14:14:46Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85072687444&doi=10.5858%2farpa.2018-0335-OA&partnerID=40&md5=727bf0ee9e80f6a72d41c378ad87fb04
dc.identifier.urihttp://hdl.handle.net/10713/11043
dc.description.abstractCONTEXT: Cystoisospora belli is an intracellular parasite associated with gastrointestinal disease in immunocompromised hosts. Although infection has been classically associated with intestinal disease, studies have identified Cystoisospora in the gallbladder of immunocompetent patients based on hematoxylin-eosin morphology. Recently, the identity of this histologic finding as Cystoisospora has been questioned based on negative results of nucleic acid studies. OBJECTIVE: To determine the prevalence of this histologic feature in pediatric patients, we retrospectively reviewed all cholecystectomy specimens from a pediatric hospital during a 24-month period. DESIGN: In 180 cholecystectomy specimens, we identified 11 cases (6.1%) with classical histologic features previously described to represent Cystoisospora organisms. To further investigate these structures, we retrieved tissue from paraffin-embedded blocks and performed electron microscopy. RESULTS: Ultrastructural examination identified ovoid perinuclear cytoplasmic structures composed of dense fibrillar aggregates rather than organisms. Patients with positive cases were similar in age to controls (positive cases: mean patient age 13.4 years [range, 2-23 years]; negative cases: mean patient age 14.7 years [range, 12 weeks-31 years]; P = .35). There was no significant association of this finding with cholelithiasis (54.5% versus 65.1%, P = .52), cholesterolosis (0% versus 22.5%, P = .12), acute cholecystitis (9.1% versus 10.1%, P > .99), or chronic cholecystitis (45.5% versus 66.3%, P = .20). CONCLUSIONS: To our knowledge, this is the first positive identification of these structures as cytoplasmic fibrillar aggregates rather than parasitic inclusions by ultrastructural examination, and the first study of this histologic finding in pediatric cholecystectomies.en_US
dc.description.urihttps://doi.org/10.5858/arpa.2018-0335-OAen_US
dc.language.isoen-USen_US
dc.publisherCollege of American Pathologistsen_US
dc.relation.ispartofArchives of pathology & laboratory medicine
dc.subjectCystoisospora bellien_US
dc.subject.meshIsosporiasisen_US
dc.subject.meshGastrointestinal Diseasesen_US
dc.subject.meshCholecystectomyen_US
dc.subject.meshCytoplasmic Structuresen_US
dc.subject.meshParasitesen_US
dc.titleCytoplasmic Fibrillar Aggregates in Gallbladder Epithelium Are a Frequent Mimic of Cystoisospora in Pediatric Cholecystectomy Specimensen_US
dc.typeArticleen_US
dc.identifier.doi10.5858/arpa.2018-0335-OA
dc.identifier.pmid30969156


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