PMC5496108_01
Abdominal computed tomography showing diffuse circumferential thickening of the colonic wall. The arrows refer to circumferential thickening of the transverse colon.
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fig1
CT of the chest, abdomen, and pelvis demonstrated diffuse circumferential colonic wall thickening with prominent mesenteric lymph nodes (Figure 1).
Colonoscopy with ulcerations in the cecum and ascending colon.
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Severe inflammation and ulcerations in the right colon and cecum were noted on colonoscopy (Figure 2).
Colonic ulcer biopsy demonstrating ischemic morphology with hyalinization of the lamina propria and atrophic crypts. Small cystic forms are evident. The arrows refer to toxoplasmosis cyst present within the colonic ulcer biopsy.
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fig3
Histologic examination revealed markedly active gastritis and colitis with ulceration and ischemic changes (Figure 3). Many free tachyzoites and encysted forms were identified in the lamina propria as well as the cytoplasm of epithelial, endothelial, and smooth muscle cells (Figures 3, 4, and 5).
Gastric biopsy specimen showing large cystic forms present in the glandular epithelium and stroma within a background of eosinophils. The arrows refer to toxoplasmosis cyst present within the gastric biopsy.
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fig4
Many free tachyzoites and encysted forms were identified in the lamina propria as well as the cytoplasm of epithelial, endothelial, and smooth muscle cells (Figures 3, 4, and 5).
Pathologic specimen with confirmation of T. gondii by immunohistochemistry. Cystic forms are present alongside dispersed tachyzoites. The arrows refer to toxoplasmosis cyst highlighted by immunohistochemistry.
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fig5
Many free tachyzoites and encysted forms were identified in the lamina propria as well as the cytoplasm of epithelial, endothelial, and smooth muscle cells (Figures 3, 4, and 5). Immunohistochemistry (polyclonal rabbit anti-Toxoplasma, 1 : 200; Dako Corporation, Carpinteria, Calif) confirmed the diagnosis of toxoplasmosis (Figure 5).