Case of the Month - November 2022 A 43-year-old man with severe bullous emphysema and chronic respiratory failure requiring continuous oxygen presented to the GI clinic for colonoscopy as a part of the evaluation for a lung transplant. He was born in Senegal, immigrated to the United States 20 years ago, and had gone back to Senegal occasionally for visits. His social history was notable for a 10 pack-year smoking history. The colonoscopy revealed a 3 cm sessile, ulcerated, non-obstructing mass in the cecum and an area of non-bleeding ulcerated mucosa. A biopsy of the mass was taken, and the histology of the colonic mucosa, shown below in Figures 1 and 2, was notable for acute inflammation, cryptitis, granulation tissue, and an organism. What is the organism? Figure 1. Cecal biopsy, H&E stain, 100X. Figure 2. Cecal biopsy, H&E stain, 1000X.