Disease, drugs, or dinner? Food histology can mimic drugs and parasites in the gastrointestinal tract
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Disease, drugs, or dinner? Food histology can mimic drugs and parasites in the gastrointestinal tract Dana Razzano 1
&
Raul S. Gonzalez 2
Received: 2 January 2020 / Revised: 27 February 2020 / Accepted: 4 March 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Microscopic foreign objects are sometimes found in gastrointestinal (GI) tract specimens. Some signify important diagnostic findings, such as parasitic or bacterial organisms and some medication resins. Partially digested fruits and vegetables can also be present, and some have been described in the literature as potential mimickers of clinically important findings. While animal protein appears as skeletal muscle on histologic examination, fruits and vegetables can show a wide variation under the microscope. To our knowledge, a thorough histologic examination of commonly eaten fruits and vegetables has not been published in the pathology literature. Herein, we present key morphologic features of fruits and vegetables that might be found in GI specimens, emphasizing potential mimics of significant pathologic findings. Keywords Fruits . Vegetables . Morphology . Mimics . Food . Medication . Parasite
Introduction Unidentifiable foreign objects are not uncommonly found in the gastrointestinal tract when evaluating tissue microscopically. Certain foreign materials signify important diagnostic findings when identified, such as parasitic or bacterial organisms, some medication resins [1], and other medication deposits like iron and calcium. Fragments of partially digested fruits and vegetables are sometimes present in biopsy and resection specimens, and some have been documented in the literature as potential mimickers of clinically important findings [2, 3]. Unlike animal protein, which will characteristically appear as skeletal muscle on histologic examination, fruits and vegetables can show a wide variation under the microscope. Until now, there has been no published thorough examination of a wide range of commonly eaten fruits and vegetables to document the
morphology seen in hematoxylin and eosin staining. Herein, we systematically present the key morphologic features that might be found in GI specimen examinations. For those that are potential mimickers, we compare the histologic features between the two similar appearing entities.
Methods We submitted 48 foods for routine histologic processing, including hematoxylin and eosin staining: & &
Fruits: apple, blueberry, cranberry, date, grape, jackfruit, kiwi, lemon, mango, orange, pineapple, raisin, strawberry, tomato, watermelon Vegetables: artichoke, asparagus, beet, bell pepper, broccoli, carrot, celery, cucumber, eggplant, garlic, ginger, green bean, kale, lettuce, okra, onion, spinach, sweet potato, zucchini Legumes: black bean, brown lentil, chickpea, peanut, red lentil Grains: bulgur wheat, corn, oat, pasta, quinoa, rice Seeds: sesame, sunflower, pomegranate
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00428-0
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