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Ultrastructural Diagnosis of Whipple& Disease at Autopsy

Published online by Cambridge University Press:  02 July 2020

S. Siew
Affiliation:
Department of Pathology, Michigan State University, East Lansing, MI , 48824 , and , Ingham Regional Medical Center, Lansing, MI , 48910
B. Newton
Affiliation:
Department of Pathology, Michigan State University, East Lansing, MI , 48824 , and , Ingham Regional Medical Center, Lansing, MI , 48910
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Extract

Whipple's disease is a rare systemic disorder with the intestinal tract being the major site of predilection. The characteristic histologic features are the infiltration of large numbers of macrophages, which have a clear or vacuolated cytoplasm. In his original documentation of “a hitherto underscribed disease”, Whipple interpreted the vacuo lation to be due to deposits of fat and fatty acids and gave the name “interstinal lipodystrophy” to the pathology. In this report, Whipple did describe the presence of rod shaped organisms in Levaditi (reduced silver) stained preparations, but, it was not until a half century later, that the definitive presence of intracellular organisms was demonstrated by means of transmission electron microscopy. Further investigations showed that the organism is a Gram positive actinomycete, which has been designated as Tropheryma whippelii.

We report the case of a 72 year old woman, who was admitted with the chief complaints of abdominal cramps and diarrhea.

Type
Pathology
Copyright
Copyright © Microscopy Society of America

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