Home Gastrointestinal Seed or Sickness? Some Digested Plant Foods Can Mimic Pathology

Seed or Sickness? Some Digested Plant Foods Can Mimic Pathology


KISSIMMEE, Fla. — The histologic structures of commonly eaten plant foods can sometimes resemble structures of diagnostic significance, such as parasites or drugs, in the gastrointestinal tract, a researcher reported here.

For example, dates and kiwi can look like the fish-scale texture of sevelamer resins (associated with GI lesions), said Dana Razzano, MD, of New York Medical College at Westchester Medical Center in Valhalla. Also, spherical okra seeds that are detached from their fibrous locules can resemble small bile acid sequestrant granules (LDL cholesterol-lowering agents), and the rounded shape and convoluted outer coats of tomato seeds bear a structural resemblance to various parasitic helminths, such as Anisakis simplex.

“Although this differential diagnosis is often quickly resolvable, awareness of the histologic appearance of certain foods may be valuable in rare situations where the identity of a foreign substance remains in doubt and a patient’s clinical information (including medication list) is unavailable,” wrote Razzano and co-authors in a poster presentation at the College of American Pathologists annual meeting.

Food material is sometimes seen in tissue samples submitted for pathologic examination, but has not been studied extensively, according to the authors.

They said they “undertook this study to record the histologic appearance of common foods, and to determine whether they can indeed resemble potentially pathogenic materials sometimes encountered in the gastrointestinal tract (eg, in colon biopsies).”

The researchers evaluated samples of 48 different food types, including grains, fruits, seeds, and vegetables. The raw foods underwent routine histologic processing, and the resultant hematoxylin and eosin-stained slides were examined for identifiable structures. They noted that “Most vegetables were composed of architecturally complex but otherwise nondescript cellulose.”

Razzano said she has not found any published cases in which a plant-based food product has been misdiagnosed as a disease state, or an abnormal finding, leading to inappropriate treatment. “However, we need to be aware that these types of foods can look like something suspicious,” she stated.

Sandor Kovacs, MD, of the University of Wisconsin at Madison, was not involved in the study, but told MedPage Today, that “We have occasionally come across these objects in examining samples. Some of these seeds and vegetable substances can look like something suspicious. This definitely is something that people have to be aware of.”

Razzano and Kovacs disclosed no relevant relationships with industry.


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