E. histolytica/dispar E. coli Endolimax nana
gingivalis
Entamoeba histolytica/Entamoeba dispar trophozoites have Trophozoites of Entamoeba
a single nucleus, which have a centrally placed karyosome coli usually measure 15 to 50
and uniformly distributed peripheral chromatin. This µm. The trophozoites
typical appearance of the nucleus is not always observed as possess a single nucleus with
some trophozoites can have nuclei with an eccentric a characteristically large,
karyosome and unevenly distributed peripheral chromatin. eccentric karyosome and
Trophozoite
The cytoplasm has a granular or "ground-glass" coarse, irregular peripheral
appearance. E. histolytica/E. dispar trophozoites usually chromatin. The cytoplasm is
measure 15 to 20 µm (range 10 to 60 µm), tending to be usually coarsely granular and
more elongated in diarrheal stool. vacuolated (often described
as "dirty" cytoplasm).
Erythrophagocytosis (ingestion of red blood cells by the Pseudopodia may be seen,
parasite) is the only morphologic characteristic that can be and are often short and blunt;
used to differentiate E. histolytica from the movement in living
nonpathogenic E. dispar. However, erythrophagocytosis is trophozoites is
not typically observed on stained smears of E. histolytica. nondirectional.
Mature Entamoeba histolytica/Entamoeba dispar cysts Cysts of Entamoeba coli are
have 4 nuclei that characteristically have centrally located usually spherical, but may be
karyosomes and fine, uniformly distributed peripheral elongated, and measure 10 to
chromatin. Cysts usually measure 12 to 15 µm. 35 µm. Mature cysts
typically have 8 nuclei but
may have as many as 16 or
more. Entamoeba coli is the
only species in the genus
encountered in humans with
more than four nuclei in the
cyst stage. The nuclei may
be seen in unstained as well
as stained specimens.
Karyosomes may be compact
or diffuse, and are usually
eccentrically located.
Cyst
Peripheral chromatin is
present and is often coarse
and granular, and irregularly
arranged along the nuclear
membrane, but may be more
uniform. The cytoplasm of
mature cysts may contain
diffuse glycogen.
Chromatoid bodies are seen
less frequently than in E.
histolytica. When present,
they are usually splinter like
with pointed ends and thus
different from the chromatoid
bodies of E. histolytica,
which have rounded ends.
E. hartmanni E. polecki Iodamoeba butschlii E.
Endolimax Trophozoites of Entamoeba Trophozoites Trophozoites of Iodamoeba There is no known cyst stage for Entamoeba
nana trophozoites hartmanni usually measure 5- of Entamoeba polecki are buetschlii measure 8 to 20 µm gingivalis; trophozoites measure 10-20 µm.
measure 6 to 12 µm and 15 µm. These trophozoites often rounded, measuring and possess a single nucleus with Trophozoites possess a single nucleus that
possess a single nucleus possess a single nucleus that 10 to 25 µm. The single a large, usually central karyosome contains a small, centrally-located karyosome
with a characteristically contains a small, compact nucleus is often distorted surrounded by refractile, and fine peripheral chromatin. The cytoplasm
large, irregularly shaped, centrally or eccentrically- and irregularly-shaped, achromatic granules. The often contains ingested leukocytes, bacteria and
blot-like karyosome. The located karyosome and fine, with a small to minute cytoplasm is coarsely granular, other debris, very rarely red blood cells. The
nucleus has no peripheral uniform peripheral chromatin. centrally-located vacuolated and can contain trophozoites also possess pseudopodia; living
chromatin. Their Nuclei are usually not visible karyosome. Peripheral bacteria, yeasts or other specimens can move quickly. Entamoeba
cytoplasm is granular and in unstained specimens. The chromatin is usually materials. Movement in living gingivalis normally lives in the gingival
often highly vacuolated. cytoplasm is finely granular. delicate and uniform. The trophozoites is sluggish and pockets near the base of the teeth in the human
Trophozoites of E. Movement in living cytoplasm is often described as nonprogressive. The mouth, and may be coughed up in sputum
nana can be difficult to trophozoites is described as vacuolated with a hyaline trophozoites of I. buetschlii can specimens. As such, it is important to
distinguish from those nonprogressive. border. Blunt pseudopodia be difficult to distinguish from the differentiate this species from E. histolytica,
of Iodamoeba buetschlii may be seen. trophozoites of Endolimax nana. which may be found in sputum from
pulmonary abscesses.
Cysts of Endolimax Cysts of Entamoeba Cysts of Entamoeba Cysts of Iodamoeba
nana are spherical to hartmanni are similar to those polecki measure 9 to 25 buetschlii vary from being nearly
ellipsoidal in shape and of E. histolytica but smaller, µm and are usually spherical to ellipsoidal, and
measure 5 to 10 µm. measuring 5-10 µm. Mature uninucleate, but binucleate measure 5-20 µm. Cysts contain
Mature cysts possess four cysts contain four nuclei that forms are seen rarely. The a single nucleus that is not visible
nuclei with large, possess a small, discrete nucleus is often large, in either unstained or iodine-
karyosomes and no centrally-located karyosome measuring up to one-third stained wet mounts. With
peripheral chromatin. and evenly-distributed of the diameter of the cyst. permanent stains (such as
The nuclei are not visible peripheral chromatin. Cysts The karyosome is trichrome), the nucleus contains a
in unstained wet mounts, may not be visible in pleomorphic, and may be large, usually eccentric
but are visible in iodine- unstained specimens. The minute to large and karyosome. Achromatic granules
stained wet mounts and cytoplasm in mature cysts may compact to diffuse, and may or may not be present around
permanent slides stained contain diffuse glycogen and centrally or eccentrically- the karyosome. An important
with trichrome. The rounded or elongated located. Peripheral diagnostic feature for this species
cytoplasm may contain chromatoid bodies with chromatin may be light to is the presence of a large compact
diffuse glycogen, but rounded ends. heavy but is usually evenly mass (vacuole) of glycogen in the
lacks chromatoid bodies. distributed. Cysts also cyst stage. Although this mass
contain an inclusion mass can be visible in unstained wet
of variable size and mounts, in iodine-stained
numerous chromatoid preparations it takes on a darker,
bodies, which may be reddish-brown color. The
small and round to large glycogen vacuole does not stain
rods with round or with trichrome, but will still be
splintered ends. visible as a well-defined mass.