Society News Now

A bizarre case of tapeworm-derived cancer causing cancer-like tumors in a Colombian man – Behind the scene story of the lab investigation


A bizarre case of tapeworm-derived cancer causing cancer-like tumors in a Colombian man – Behind the scene story of the lab investigation

A bizarre case of tapeworm-derived cancer causing cancer-like tumors in a 41-year-old Colombian man has got lot of media attention recently and emphasized again the role of laboratory analysis in complex case investigations. “The key for the diagnosis of this unusual case was combined use of various laboratory techniques – conventional pathology and advanced molecular biology, and synergy among clinicians, pathologists and lab scientists to solve this mystery,” said Dr. Julu Bhatnagar, Ph.D., one of the primary authors of the report published in the November 5 issue of the New England Journal of Medicine and Team Lead of the Molecular Pathology Section in CDC’s Infectious Diseases Pathology Branch (IDPB).

In 2013, doctors in Colombia asked CDC to help diagnose biopsies with strange pattern from lung tumors and lymph nodes of a HIV positive man who was non-adherent to therapy. The man presented with fatigue, fever, cough, and weight loss of several months' duration, and lung, liver and adrenal nodules and enlarged lymph nodes. “Initial histopathological analysis was very puzzling, as the growth pattern was cancer like, but the cells were about 10 times smaller than a normal human cancer cells and they were fusing together, which is rare for human cells. The question was if we were dealing with an unfamiliar, possibly unicellular, eukaryotic organism or rare type of cancer? So, it was decided to proceed for the molecular analysis of the tissue specimens.” Dr. Bhatnagar said.

“Every year, IDPB receives thousands of tissue specimens to provide assistance in investigations of infectious disease of unknown etiologies, unexplained illnesses/deaths and outbreaks; consequently, the Molecular Pathology Lab has uniquely developed more than 150 polymerase-chain-reaction (PCR)-based assays and other cutting edge techniques such as pyrosequencing, in-situ hybridization (ISH) and laser microdissection for the identification of wide-array of pathogens, including bacteria, viruses, parasites and fungi from tissue specimens. Since in this case, initial suspicion was on plasmodial slime mold because of syncytia formation, I started with some broad-range PCR tests targeting slime mold (Myxogastria) and other eukaryotes using DNA extracted from the tissue specimens. By gel electrophoresis of initial PCRs, I saw some faint bands of DNA (PCR products), I decided to make PCRs less stringent and repeated. This time, I got the bands of DNA that I was able to sequence. The result of sequence analysis was completely surprising, as the DNA sequences matched with Hymenolepis nana, a dwarf tapeworm. I could not believe my own results. I tried another PCR, this time specifically targeting cestodes. The resulting DNA sequencing showed 99% identities with Hymenolepis nana again. I searched the literature and interestingly found a case report from Dr. Olson’s group (Natural History Museum, London) related to H. nana infection that showed an image of similar tiny cells in a HIV-positive man.  Feeling more confident now, I sent the results to Dr. Atis Muehlenbachs, a pathologist handling the case, other pathologists of the group and Dr. Sherif Zaki, Chief of the IDPB. They were as surprised as I was. One of them actually predicted in advance and said, “This is really exotic -- case of the decade!” It was concluded after further review that the tiny cells in the lymph nodes of our patient was certainly very similar to the ones showed in Dr. Olson’s case report. Although there were some unanswered questions, Dr. Muehlenbachs quickly contacted doctors in Colombia and informed about the diagnosis. However, unfortunately, patient was in palliative care at that time and died 72 hours after the diagnosis. No specific treatment was attempted.”

“Even though the patient died, our investigation continued, as there was a question if we could actually localize H. nana DNA in those tiny cells to confirm that the cells originated from a tapeworm,” said Dr. Bhatnagar. “Dr. Zaki suggested attempting in-situ hybridization. I designed and prepared DNA probes using H. nana DNA that we amplified from the patient’s samples. Simultaneously, probes targeting human Alu DNA sequences were prepared. In-situ hybridization was attempted and this time showed what we were expecting - H. nana DNA probe signals were detected in the proliferative tiny cell clusters, while human Alu probe signals detected in the surrounding human tissue. So, this issue was resolved.”

“The next goal was to confirm the species and to obtain more information about the phylogeny,” Dr. Bhatnagar said. “For this, I tried hymenolepidid-species specific PCR targeting mitochondrial gene CO1 and sequenced the DNA obtained from the PCR products. This case had never seized to amaze us – the sequence was beautiful, but I found some gene mutations. I repeated the sequencing twice and the results remained the same. I shared the sequences with Dr. Muehlenbachs, and he almost jumped out of his chair. He thought the mutations were very similar to the ones that we see in human cancer. I could not agree more. All the papers that I read during my early training years while getting my Ph.D. related to the gastrointestinal tumor markers were coming back to mind.”

“Now, the big question was- if the tapeworm had the cancer or muteted geneS for cancer? We thought we could only get the answer by deep-sequencing of the whole genome of the H. nana. But, at that time, we did not have next-generation sequencing facility in our lab. Next day, Dr. Muehlenbachs and I was sitting in the office of Dr. Michael Frace, Ph.D., CDC’s Biotechnology Core facility to discuss about the project. He mentioned that comparative deep sequencing could be attempted, but could we get him DNA from normal H. nana control? Dr. Muehlenbachs contacted Dr. Olson and others to get us control DNA/tissue so that we can prepare specially treated DNA for deep sequencing. Deep sequencing of the specimens from the patient revealed 6 insertional mutations (5 associated with protein coding genes) and comparative analysis identified H. nana structural genomic variants that are compatible with mutations described in cancer.”

“To a certain extent, mystery solved for this case.” said Dr. Bhatnagar. “Still, there are several unanswered questions and I am optimistic that if experts of several different areas work together collaboratively, some day we will find all the answers and unravel many new facts.” However, Dr. Bhatnagar, who was previously involved in several interesting case investigations including Clostridium sordellii septic shock syndrome associated with medical abortions, has cautioned against reading too much from a single case investigation.

Society News Now, Issue #12

A monthly update on activities occurring on behalf of the members of the American Society for Clinical Laboratory Science

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Issue 12 November 2015

In This Issue:

Clinical Laboratory Educators' Conference

Student Forum  │  Patient Safety Committee

New Professional and New Member Forum

The Education and Research Fund, Inc 2016-17 Committee Appointments

Clinical Laboratory Educators’ Conference:  Registration is now open for CLEC, which is scheduled in Minneapolis, MN February 25-27, 2016. On-line registration is available at  Join your colleagues for an informative conference!

Student Forum:  The Student Forum Annual Yankee Candle fundraiser is ongoing.  Funds will support travel grants for students to the ASCLS 2016 Legislative Symposium in Washington, DC and the 2016 Annual Meeting in Philadelphia.  Items purchased will be shipped directly to your home.  Please visit to support the Student Forum!

Patient Safety Committee:  The PSC members submit monthly articles to the COLA sponsored web site Lab Testing Matters.  This month’s article describes how laboratory professionals can improve the quality of laboratory services using the Institute of Medicare Quality Aims and Competencies.  See to read this article and others submitted by the ASCLS Patient Safety Committee members.

New Professional and New Member Forum:  The forum will be creating a Facebook page for all new members and new professionals in mid-November.  Share your comments, questions, concerns and experiences with the group.  The group will be called “ASCLS New Professionals and New Members”.

The Education and Research Fund, Inc:  The E&R Fund, Inc. provides scholarships to Clinical Laboratory Science undergraduate and graduate students.  A scholarship to honor Bernadette “Bunny” Rodak has been established in recognition of her superb contributions to the discipline of hematology, through her textbooks, her dedication to ASCLS and her service on the ASCLS Consumer  Response team.  Individuals and/or state societies are invited to contribute through the “Donate” link on the ASCLS home page:  Choose E&R Fund, and complete the donation page.

ASCLS 2016-2017 Committee Appointments:  A call for volunteers to serve on ASCLS Committees for the coming year has been emailed to all members and published in ASCLS Today.  If you are interested in serving on a committee, please complete the information requested at:  


Society News Now, Issue #11

A monthly update on activities occurring on behalf of the members of the American Society for Clinical Laboratory Science

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Issue 11 October 2015

In this Issue:

Membership Committee

ASCLS Executive Committee Meeting and Upcoming Board of Directors Conference Call


Diversity Advocacy Council

Membership Committee

The ASCLS Membership Committee has implemented a Regional Member Rewards competition. The Region that recruits the most new PF1 and PF2 members through the Member Rewards program will be able to show they are NUMBER 1 by receiving special victory buttons at the annual meeting in Philadelphia. Review the Member Rewards program on the ASCLS website under the Join tab, Current Membership Promotions .

Do you know of an up and coming shining star in your state or region? The “ASCLS Voices Under 40” program will recognize ASCLS members under the age of 40 who have shown exceptional commitment to ASCLS, the laboratory profession, and their community at large. Honorees will be recognized at the annual meeting in Philadelphia in August, 2016 and may be spotlighted in future issues of ASCLS Today, on the website and on social media. Their employers will also receive notification of the recognition. Application and more information can be found here: .

ASCLS Executive Committee Meeting and Upcoming ASCLS Board of Directors Conference Call

The ASCLS Executive Committee, a subset of the Board of Directors, met in Philadelphia in September. Among the many issues discussed was the new logo for the Society. You may remember there was a contest last spring and several good proposed logos were submitted. The winning logo was similar to the banner on the ASCLS Website home page, so the Executive Committee voted to use that banner for our “official” logo. The logo retains the beloved triangles, so there is no need to replace society pins or other materials. Feel free to copy the banner from the web site and incorporate it into your regional and state reports.

The Executive Committee also discussed several task forces that were approved by the full board in August. Members will be notified soon by the Task Force Chairs to begin their work. The full Board of Directors will meet by conference call on October 26.

Annual Meeting Steering Committee (AMSC) and Advanced Management Institute (AMI)

Members met in Philadelphia, the site of the 2016 ASCLS Annual Meeting, to begin planning the programs for both of these events.  The Abstract and Proposal Review Committee and Scientific Assemblies actively solicited proposals; over 200 proposals were reviewed and ranked as part of the process for determining the educational offerings for both the AMI and the Annual Meeting.  The AMSC members are now working to solidify the proposals and develop speaker contracts. The Philadelphia Host Committee and the ASCLS-PA members are very excited to welcome ASCLS back to the City of Brotherly Love and Sisterly Affection after 13 years!

You may know that Pope Francis visited the US and Philadelphia in September. The website “Checkin” ( featured an article written by Natalia Kvitek titled “48 Hours in Philly …With the Pope”. An excerpt from the websiteappears below, suggesting that the Pope should have stayed at the Loews Hotel, the beautiful hotel ASCLS members will be based in during the 2016 Annual Meeting.

“The Pope has shunned the decadent Papal apartment in the Vatican in favor of much simpler lodging, but when he travels, he can hardly be put up in a rooming house. Philadelphia has no lack of beautiful hotels but we think he would appreciate the  Loews Philadelphia Hotel . Housed in a 1930’s building that holds the title of our nation’s first skyscraper, he might even indulge in a cheeky swim in the hotel pool. In-room WiFi means he can comfortably surf the web, or reply to messages from his adoring worldwide fanbase. Plus, the view from the suites will remind him of just how blessed he is.“

Patient Safety Committee and the Promotion of the Profession Committee

The members of these two committees have worked together to develop the 2016 ASCLS Patient Safety Calendar.  The calendar promotes our role as medical laboratory professionals in patient safety and highlights our profession and our important days each month.  It is now available for purchase in theASCLS Online Store !  The cost per calendar is $10 and includes shipping. The deadline to order has been extended to October 15, 2015. The calendar is also available as a free digital download.  Visit thePromotion of the Profession websitefor more information.

Diversity Advocacy Council

Attention all ASCLS MEMBERS!  We are gathering historical moments of ASCLS and we would like copies of your pictures and testimonials for an archive project.  The purpose of this project is to compile these moments into a slideshow for viewing at the ASCLS Annual Meeting.  We are also accepting recorded files with your stories: tell us about an experience you have had in your past that has had a large effect in your life/profession while working in health care.  The Diversity Advocacy Council would like your input byNovember 30th!  Please send your submissions to .  If you have any trouble scanning your pictures or sending your recordings please let us know and we will help troubleshoot.

In addition, we would appreciate some volunteers who might be willing to assist in helping put the slideshow together. If you are interested, please also respond to the email listed above.  We would love to hear your input. Please contact us with your comments.  


Society News Now, Issue #10

A monthly update on activities occurring on behalf of the members of the American Society for Clinical Laboratory Science


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Issue 10 June 2015

In this Issue:

Annual Meeting News ASCLS Governance at the Annual Meeting in Atlanta 

Opportunities to Pay It Forward Awards

Committee and Forum NewsAnnouncements

Annual Meeting News:

July is fast approaching, and that means the ASCLS Annual Meeting in Atlanta is just around the corner.  This is a not-to-be-missed event for members and non-members alike, and you can still register at a cost savings through July 5th. Take advantage of this extended deadline and register now to attend the 83rd ASCLS Annual Meeting, Advanced Management Institute and Exposition.  Rooms may still be available at the Omni Hotel at CNN Center, the ASCLS headquarters hotel, and you have until July 6th to receive the ASCLS discounted room rate. Reserve your room today !

ASCLS Governance at the Annual Meeting in Atlanta:

Do you wonder how decisions are made on your behalf in ASCLS?  When you are in Atlanta, take advantage of these opportunities to learn about the workings of ASCLS.

  • ASCLS Board of Directors Meeting, Tuesday morning, July 28: The ASCLS Board of Directors only meets in-person twice a year – once prior to the Legislative Symposium and at the Annual Meeting. All members are welcome to attend, to listen to the Board’s deliberations, and to take part in discussions.
  • ASCLS Committee Meetings, Tuesday afternoon, July 28: Most of the ASCLS standing committees have their in-person meetings scheduled for Tuesday afternoon, and you don’t have to be a committee member to attend. Want to learn more about the Patient Safety Committee? What about Promoting the Profession or Government Affairs? Check the governance schedule and attend those meetings that interest you.
  • Issues Update and Forum, Thursday morning, July 30: This session is where Cindy Johnson, ASCLS Secretary-Treasurer will provide a financial report, the President-Elect candidates will give their speeches, and other issues of importance to members will be presented.
  • Regional Caucuses, Friday morning, July 31: Be sure to attend your Regional Caucus for an opportunity to discuss the candidates for election, and to talk about the issues that are coming to the House of Delegates for action.
  • Elections, Friday morning, July 31, right after your Regional Caucus: ASCLS delegates will elect a President-Elect, Regional Directors, a Judicial Committee member, and members of the Nomination Committee. State Presidents need to make certain that their delegates are credentialed before elections. If you have questions about Credentials, contact Charlie Francen, Credentials Chair.
  • ASCLS House of Delegates, Saturday morning, August 1: In addition to the standing agenda items, this year ASCLS delegates will be voting on a Patient Safety Position Paper, and discussing the ASCLS Diversity Task Force’s definition of diversity. Come prepared with your comments and suggestions. Let’s have some lively discussion on the floor of the House this year!

Opportunities to Pay it Forward at the ASCLS Annual Meeting:

  • The ASCLS Education & Research (E & R) Fund Silent Auction will be held in conjunction with the President’s Reception on Wednesday evening, July 29.   Constituent societies are once again encouraged to donate to the auction and reminded to notify the ASCLS office about their donations so these donations can be promoted. I still use my beautiful carved wooden pitcher/wall art and proudly wear my Joe Mauer Minnesota Twins jersey. Proceeds support the E & R scholarships and grants.
  • This year StandUp For Kids - Atlanta has been selected as the HOPE project by the ASCLS Promotion of the Profession Committee (PPC). StandUp For Kids works to end youth homelessness in Atlanta. ASCLS will be helping to provide hygiene kits containing such items as travel sized deodorant, soap, shampoo and toothpaste. You can also make a monetary donation through the ASCLS website, or on-site at the meeting. Details can be found on the ASCLS website.
  • The Student Forum and New Professionals and New Members Forum will also hold a silent auction during the First Timers' and Students' Reception on Tuesday evening, July 28. The proceeds from this silent auction support travel and educational scholarships for worthy students.


  • Don’t miss out on the ASCLS Awards Ceremonies this year, when we honor our industry partners, and our members and Constituent Societies who have done great things for ASCLS. Industry awards are presented on Wednesday morning; the other awards are presented on Thursday at 5:30 pm, and at the House of Delegates on Saturday morning.
  • The Cardinal Health 2015 urEssential Award winner is ASCLS member, Microbiology Scientific Assembly Chair, and Incoming TACLS President, Dr. Rodney Rohde. Rodney has touched the lives of many over the years, as a teacher/mentor and researcher, as well as an active member of ASCLS. He is very deserving of this award. Other finalists for the Cardinal award were Dr. Patricia Tille (SD) and Marcia Armstrong (HI), also members of ASCLS.
  • ASCLS members were recently featured in the blog,, as one of the "20 Professors of Clinical Laboratory Science You Should Know". The list is comprised of outstanding professors in the field and recognizes their great contributions to academia; all 20 are ASCLS members! Congratulations to Sue Beck, Rodney Rohde, Nadine Fydryszewski, Yazmen Simonian, Linda Smith, Mary Ann McLane, Sally Pestana, Karen Chandler, Lynne Williams, Shauna Anderson Young, Kathy Doig, Cathy Otto, Pat Tille, Kay Rasmussen, Linda Pifer, Kathy Kenwright, Karen Honeycutt, Tera Webb and Tim Randolph. It is always great to see our educators recognized for outstanding service!

Committee and Forum News:

Although everyone is gearing up for the Annual Meeting and the transition to the 2015-16 year, the ASCLS Committee work continues. Here are some highlights:

  • Membership Committee: The renewal of your ASCLS membership continues to be a priority. If you haven’t had a chance to renew your VOICE and VISION for the laboratory profession, take the time to do so now. We value your membership! Your continued support, through membership, allows ASCLS to work for you and for the profession.  The Membership Committee has been working on a recognition program for members – spotlighting those ASCLS Voices under 40. This program will be addressed at the Tuesday, July 28 ASCLS Board of Directors meeting so come and participate in the discussion. The goal is to increase awareness of the efforts and successes of this very promising group of individual
  • Government Affairs Committee: The GAC continues to follow and respond to issues involving legislation and government regulations that affect the practice of laboratory medicine. Recently, the U.S. Supreme Court upheld the legality of subsidies under the ACA (also known as Obama Care). For us and all healthcare providers it means the new patients you have been seeing (if that is the case) will continue to have health insurance and access to affordable healthcare.  The House and Senate Appropriations Committees each have approved their FY 2016 Labor-HHS-Ed spending bills, which provides $477.67 million (House) or $450.97 million (Senate) for Title VII and Title VIII combined, compared to the President’s FY 2016 budget of $469.45 million. Title VII and Title VIII funds are used to support educational opportunities for those in healthcare related fields.
  • New Professionals and New Members ForumThis forum has developed a pilot mentoring program in conjunction with the Leadership Development Committee to meet the needs of students and young professionals in ASCLS. This mentoring program will be made available to those students and new professionals who have been appointed to national, regional or state ASCLS committees and want to understand their responsibilities and have a positive experience.


  • Reminder: The ASCLS National Office and helpful staff are ready to assist you if you have any comments, questions or concerns. This can include membership renewal, preparations for the Annual Meeting, or general questions. Please or 571-748-3770.
  • ASCLS Leadership Academy: The latest class of emerging leaders in the ASCLS Leadership Academy will be graduating at the Annual Meeting and will be presenting their infographics project at a session titled Explore ASCLS through Infographics: A visual collaboration of the Laboratory Profession and Professional Representation on Thursday July 30 at 12:30 pm. As Class #8 graduates, a new class of leaders will begin their year-long activities at the Annual Meeting. Show your support for this successful program entering its ninth year preparing our future leaders for positions not only in ASCLS but in their workplace.
  • Proposals for the 2016 Annual Meeting and/or Advanced Management Institute : Do you have an idea for an education session at the 2016 Annual Meeting and/or Advanced Management Institute (AMI)? If so, please submit your proposal by August 11th. Proposals can be submitted electronically at the following website: Or if you prefer to submit your proposal manually, you can access the form on theAnnual Meeting website.

Society News Now, Issue #9

A monthly update on activities occurring on behalf of the members of the American Society for Clinical Laboratory Science

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Issue 9 May 2015

In this Issue:

ASCLS Annual Meeting Governance in AtlantaMembership Committee (MC)

Membership Renewal │Paper and Poster Competition Focused on Quality

Government Affairs Committee (GAC) New Professionals and New Members Forum Travel Grant

ASCLS Beckman Coulter Travel Grant Winners │ Announcements

ASCLS Annual Meeting Governance in Atlanta
Constituent societies have chosen their delegates, and the delegations are making preparations to fulfill their responsibilities at the ASCLS Annual Meeting.  Information about credentialing the delegates has been forwarded to constituent society Presidents, who lead their delegations.  In addition to Elections, one of the items coming before the House of Delegates for debate and approval will be a patient safety position paper, currently being written by the Patient Safety Committee.  ASCLS Committees are starting to wrap up their work for this year, and are already making plans for their in-person meetings in Atlanta.  All members, not just delegates, attending the Annual Meeting should consider coming early to attend the AMI (Advanced Management Institute), the ASCLS Board Meeting, and the Committee meetings that take place on Tuesday, after the ASCLS Board Meeting.  
Membership Committee
Among the many things the Membership Committee is working on is the Young Professional Spotlight, and a return on investment value calculator, demonstrating the value of ASCLS membership.  They are also working on a smart phone application, and are looking for volunteers to help with the design.  If you are interested in helping the Membership Committee work on this app, please contact Holly Weinberg, Chair.  
Membership Renewal
ASCLS is entering the membership renewal cycle, and the opportunity for you, as members, to show your ongoing support for ASCLS and the work we do on your behalf, and for the clinical laboratory science profession.  On-line renewal is easy, as long as you are not changing your membership type.  Just remember to log into the ASCLS Website first.  If you want to change your membership type from last year (for example changing from a Collaborative membership to Professional I or II), contact the ASCLS Office at 571-748-3770. Thank you, in advance, for your membership as we continue to provide One Voice, One Vision.  
Paper and Poster Competition Focused on Quality
With generous support from Bio-Rad Laboratories, ASCLS is offering members the opportunity to showcase their quality projects or case studies, and win a cash award, registration, and travel support to attend the 2015 ASCLS Annual Meeting.  One professional/graduate student and one undergraduate student will be selected.  The deadline is June 15, so submit your analytical quality management paper or poster today! Visit for more information.
Government Affairs Committee
The Centers for Medicare and Medicaid (CMS) has announced that July 16, 2015 will be the date of its annual meeting to receive comments and recommendations for payment amounts on new and revised Medicare laboratory codes.  The announcement was in the Federal Register, but the link to the list of codes being considered for Calendar Year 2016 doesn’t seem to be working, so stay tuned for more information.  
New Professionals and New Members Forum Travel Grant
Applications are being accepted for a $400 travel stipend to attend the 2015 ASCLS Annual meeting.  Recipients are encouraged to maintain their ASCLS membership and provide active service to the society.  Download the application and submit by June 1, 2015.
ASCLS Beckman Coulter Travel Grant Winners
ASCLS student members were provided an opportunity to apply for a grant to assist with travel expenses to attend the Annual Meeting in Atlanta.  Thanks to the generosity of Beckman Coulter $5000 was available to six students to attend and experience the Annual Meeting and Clinical Lab Expo.  The following students were selected to receive grants:
  • Joshua Bugbee of Millbury, OH
  • Elizabeth LeFors of Fountain, CO
  • Hollie Hatch of Ketchum, ID
  • Meghan Colvin of Cypress, TX
  • Beth Hughes of Monroe, LA
  • Courtney Hall of Albany, GA
  • The Promotion of the Profession Committee is soliciting entries for the Charitable Activities Award, which recognizes constituent societies that have given back to their communities.  Deadline for submissions is June 1!  
  • Don’t Delay!  Register for the ASCLS Annual Meeting by June 8 for discounted fees.
  • ASCLS Advanced Management Institute (AMI) is July 26-27.  Take advantage of this pre-meeting management conference dedicated to challenges and opportunities facing laboratory managers and decision makers.  Information about the sessions can be found on the Annual Meeting and AMI website
  • The ASCLS Career Fair will be held Friday, July 31 during the Annual Meeting.  Registration is free to job seekers.