The patient is a 59-year-old man with a history of hyperthyroidism, gout, and hypertension. He presented to the emergency room with severe dehydration, electrolyte abnormalities, and a 50-pound weight loss due to severe chronic unexplained diarrhea. He described his stools as frequent (up to 30 per day), voluminous, and oily. Infectious panel including C. diff., HIV, hepatitis B, P-ANCA, and antiendomysial antibody was negative. Fasting serum gastrin was within normal limits.
The patient was hospitalized, and an endoscopy with biopsies was performed.
Natalya Shlyakhova, M.D.
Fellow, Surgical Pathology
Vishal Chandan, M.B.B.S.
Consultant, Division of Anatomic Pathology
Associate Professor of Laboratory Medicine and Pathology
Mayo Clinic College of Medicine