Studies in the cellular exudates of the bowel discharges* ii. the differential diagnosis of amebiasis. types of cells found in bowel discharges of patients with bowel complaints

Summary

During the past four years, studies in the cellular exudates of bowel discharges have established that the presence of cellular exudates in the bowel discharge indicates pathological change in the bowel wall, while the absence of cellular exudate points to bowel conditions not associated with anatomical changes in the bowel wall.

The bowel discharges of patients suffering from various pathological conditions of the bowel contain three well-defined types of cell which may be readily identified. These types include (1) large cells with prominent nuclei. These cells have a clearly defined ectoplasm. The nuclei have a definite nuclear structure which at times is beaded with either delicate or heavy granules of chromatin matter. While these cells are entirely different from the Endameba histolytica, they are frequently confused with them and as a result a mistake is made in the diagnosis and treatment of the patient. (2) Polymorphonuclear leucocytes which, in the wet stained preparation, may or may not have open ringed nuclei or solid nuclei similar to those seen in the methylene blue. Those which have open ringed and beaded nuclei are frequently mistaken for cysts of amebae. However, these may be differentiated by a careful study of the specimens. (3) Epithelial cells of various sizes and shapes are found. With the methylene blue preparation, these may be readily demonstrated.

No cells of any of these types have been found in any autopsy specimens that have been examined. They are characteristic of pathological change in the bowel wall. Studies are now in progress in which an attempt is being made to arrive at a provisional diagnosis of the type of pathological change in the bowel mucosa from the type of the cellular exudates. The results of these studies will be made available in the near future.