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Tamponi C, Cavallo L, Dessì G, Sardu F, Carta C, Corda A, Burrai GP, Varcasia A, Scala A. Hepatobiliary Ascariasis in a Piglet. Acta Parasitol 2024; 69:785-790. [PMID: 38424402 PMCID: PMC11001663 DOI: 10.1007/s11686-024-00813-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/19/2024] [Indexed: 03/02/2024]
Abstract
PURPOSE Ascariasis caused by the helminth Ascaris suum is the most common parasitosis of swine worldwide and it may involve all age categories of pigs. The present study reports an unusual localization of A. suum worms in the biliary system of a piglet slaughtered for human consumption. METHODS The liver was subjected to ultrasound scan and pathological examination. The isolated worms were morphologically examined and the DNA was extracted for the molecular identification of the species involved. RESULTS A total of 43 preadult nematodes were found within the gallbladder and the bile ducts. Parasites were morphologically identified as belonging to the genus Ascaris and molecularly as A. suum. At gross examination, the liver was moderately enlarged, with the bile ducts severely dilated. A chronic inflammatory infiltrate was noted, often centered around ectatic bile ducts (up to 5 mm in diameter), lined by hyperplastic epithelium and filled with sections of nematodes. The worm sections showed smooth cuticle, coelomyarian musculature, and an intestinal tract lined by columnar, uninucleated cells within a pseudocoelom. The ex vivo ultrasonographic examination of the liver allowed the visualization of several nematodes in the bile duct lumen and could be suggested for in vivo diagnosis. Unfortunately, the absence of the intestine did not allow to define the pathogenesis of the infection. CONCLUSION Although, given the unusual nature of this finding, it is difficult to identify predisposing factors for this A. suum localization, it suggests that ascariasis should be considered in the differential diagnosis of pigs with hepatobiliary disease.
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Affiliation(s)
- Claudia Tamponi
- Department of Veterinary Medicine, University of Sassari, Via Vienna, 2, 07100, Sassari, Italy
| | - Lia Cavallo
- Department of Veterinary Medicine, University of Sassari, Via Vienna, 2, 07100, Sassari, Italy
| | - Giorgia Dessì
- Department of Veterinary Medicine, University of Sassari, Via Vienna, 2, 07100, Sassari, Italy
| | | | - Carlo Carta
- Department of Veterinary Medicine, University of Sassari, Via Vienna, 2, 07100, Sassari, Italy
| | - Andrea Corda
- Department of Veterinary Medicine, University of Sassari, Via Vienna, 2, 07100, Sassari, Italy
| | - Giovanni Pietro Burrai
- Department of Veterinary Medicine, University of Sassari, Via Vienna, 2, 07100, Sassari, Italy
| | - Antonio Varcasia
- Department of Veterinary Medicine, University of Sassari, Via Vienna, 2, 07100, Sassari, Italy.
| | - Antonio Scala
- Department of Veterinary Medicine, University of Sassari, Via Vienna, 2, 07100, Sassari, Italy
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Tamarozzi F, Fittipaldo VA, Orth HM, Richter J, Buonfrate D, Riccardi N, Gobbi FG. Diagnosis and clinical management of hepatosplenic schistosomiasis: A scoping review of the literature. PLoS Negl Trop Dis 2021; 15:e0009191. [PMID: 33764979 PMCID: PMC7993612 DOI: 10.1371/journal.pntd.0009191] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Hepatosplenic schistosomiasis (HSS) is a disease caused by chronic infection with Schistosma spp. parasites residing in the mesenteric plexus; portal hypertension causing gastrointestinal bleeding is the most dangerous complication of this condition. HSS requires complex clinical management, but no specific guidelines exist. We aimed to provide a comprehensive picture of consolidated findings and knowledge gaps on the diagnosis and treatment of HSS. METHODOLOGY/PRINCIPAL FINDINGS We reviewed relevant original publications including patients with HSS with no coinfections, published in the past 40 years, identified through MEDLINE and EMBASE databases. Treatment with praziquantel and HSS-associated pulmonary hypertension were not investigated. Of the included 60 publications, 13 focused on diagnostic aspects, 45 on therapeutic aspects, and 2 on both aspects. Results were summarized using effect direction plots. The most common diagnostic approaches to stratify patients based on the risk of variceal bleeding included the use of ultrasonography and platelet counts; on the contrary, evaluation and use of noninvasive tools to guide the choice of therapeutic interventions are lacking. Publications on therapeutic aspects included treatment with beta-blockers, local management of esophageal varices, surgical procedures, and transjugular intrahepatic portosystemic shunt. Overall, treatment approaches and measured outcomes were heterogeneous, and data on interventions for primary prevention of gastrointestinal bleeding and on the long-term follow-up after interventions were lacking. CONCLUSIONS Most interventions have been developed on the basis of individual groups' experiences and almost never rigorously compared; furthermore, there is a lack of data regarding which parameters can guide the choice of intervention. These results highlight a dramatic need for the implementation of rigorous prospective studies with long-term follow-up in different settings to fill such fundamental gaps, still present for a disease affecting millions of patients worldwide.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Veronica A. Fittipaldo
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Hans Martin Orth
- Department of Gastroenterology, Hepatology and Infectious Diseases, Duesseldorf University Hospital, Heinrich Heine University, Düsseldorf, Germany
| | - Joachim Richter
- Institute of Tropical Medicine and International Health, Charité Universitätsmedizin, Berlin, Germany
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Niccolò Riccardi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Federico G. Gobbi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
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Dessein H, Duflot N, Romano A, Opio C, Pereira V, Mola C, Kabaterene N, Coutinho A, Dessein A. Genetic algorithms identify individuals with high risk of severe liver disease caused by schistosomes. Hum Genet 2020; 139:821-831. [PMID: 32277285 DOI: 10.1007/s00439-020-02160-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/28/2020] [Indexed: 02/06/2023]
Abstract
Schistosomes induce severe hepatic disease, which is fatal in 2-10% of cases, mortality being higher in cases of co-infection with HBV or HCV. Hepatic disease occurs as a consequence of the chronic inflammation caused by schistosome eggs trapped in liver sinusoids. In certain individuals, the repair process leads to a massive accumulation of fibrosis in the periportal spaces. We and others have shown that genetic variants play a crucial role in disease progression from mild to severe fibrosis and explain why hepatic fibrosis progresses rapidly in certain subjects only. We will review here published findings concerning the strategies that have been used in the analysis of hepatic fibrosis in schistosome-infected individuals, the genetic variants that have associated with fibrosis, and variants in new pathways crucial for fibrosis progression. Together, these studies show that the development of fibrosis is under the tight genetic control of various common variants with moderate effects. This polygenic control has made it possible to develop models that identify schistosome-infected individual at risk of severe hepatic disease. We discuss the performances and limitations of these models.
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Affiliation(s)
- Hélia Dessein
- BILHI Genetics, 60 Avenue André Roussin, 13016, Marseille, France
- UMR_S906-Génétique Et Immunologie Des Maladies Parasitaires, Aix Marseille Université-INSERM, Marseille, France
| | - Nicolas Duflot
- BILHI Genetics, 60 Avenue André Roussin, 13016, Marseille, France
- UMR_S906-Génétique Et Immunologie Des Maladies Parasitaires, Aix Marseille Université-INSERM, Marseille, France
| | - Audrey Romano
- BILHI Genetics, 60 Avenue André Roussin, 13016, Marseille, France
- UMR_S906-Génétique Et Immunologie Des Maladies Parasitaires, Aix Marseille Université-INSERM, Marseille, France
| | - Christopher Opio
- Department of Medicine, Mulago Hospital, Makerere University College of Health Sciences, Kampala, Uganda
| | - Valeria Pereira
- Instituto Aggeu Magalhães, Fiocruz, Fundaçao Oswaldo Cruz, Av. Professor Moraes Rego, S/N Cidade Universitária, Recife, PE, 50740-465, Brazil
| | - Carla Mola
- Instituto Aggeu Magalhães, Fiocruz, Fundaçao Oswaldo Cruz, Av. Professor Moraes Rego, S/N Cidade Universitária, Recife, PE, 50740-465, Brazil
| | - Narcis Kabaterene
- Vector Control Division Uganda, Ministry of Health, Queen's Ln, Kampala, Uganda
| | - Ana Coutinho
- Fundação Oswaldo Cruz Rio de Janeiro, Av. Brasil, 4365, Rio de Janeiro, RJ, 21040-360, Brazil
| | - Alain Dessein
- BILHI Genetics, 60 Avenue André Roussin, 13016, Marseille, France.
- UMR_S906-Génétique Et Immunologie Des Maladies Parasitaires, Aix Marseille Université-INSERM, Marseille, France.
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Sood V, Chaudhari SR, Borle D, Sureka B, Bihari C, Kumar S. Cystic Presentation of Hepatic Schistosomiasis. Indian J Pediatr 2018; 85:313-315. [PMID: 28924731 DOI: 10.1007/s12098-017-2468-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 08/28/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Vikrant Sood
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, 110070, India.
| | - Sachin Ramesh Chaudhari
- Department of Pathology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, India
| | - Deeplaxmi Borle
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, India
| | - Binit Sureka
- Department of Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, India
| | - Chhagan Bihari
- Department of Pathology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, India
| | - Senthil Kumar
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi, India
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Thijs L, Messiaen P, van der Hilst J, Madoe V, Melis C, Van Eyken P, Vanmoerkerke I, Janssens F. Hepatic schistosomiasis with massive splenomegaly: a case report and literature review. Acta Gastroenterol Belg 2018; 81:93-96. [PMID: 29562382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Schistosomiasis is a parasitic disease caused by Schistosoma species. Intestinal and hepatic schistosomiases are the most common forms of chronic disease. We describe a case of a 26-year old patient from Eritrea who was referred to our hospital with abdominal pain and diarrhea. The diagnosis of hepatosplenic schistosomiasis was made by liver biopsy and the patient was treated with praziquantel. Hepatic schistosomiasis is characterised by deposition of schistosomal eggs in the liver which results in a host cell immune response and leads to granuloma formation and neoangiogenesis. This is hallmarked by different grades of periportal fibrosis with portal hypertension leading to splenomegaly. Normal liver architecture is preserved and periportal fibrosis can be reversible if treated adequately and timely. With a recent native schistosomiasis cluster report from France and the expected influx to Europe of persons from regions endemic for schistosomiasis, increased awareness of this disease in healthcare practitioners is needed. We review the epidemiology, pathogenesis, clinical presentation and treatment of schistosomiasis.
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Affiliation(s)
- L Thijs
- Department of Gastroenterology and Hepatology, Jessa Ziekenhuis Hasselt, Belgium
- Department of Haematology, Jessa Ziekenhuis Hasselt, Belgium
| | - P Messiaen
- Department of Infectious Diseases and Immunity, Jessa Ziekenhuis Hasselt, Belgium
- BIOMED research institute, Hasselt University, Belgium
| | - J van der Hilst
- Department of Infectious Diseases and Immunity, Jessa Ziekenhuis Hasselt, Belgium
- BIOMED research institute, Hasselt University, Belgium
| | - V Madoe
- Department of Haematology, Jessa Ziekenhuis Hasselt, Belgium
| | - C Melis
- Department of Pathological Anatomy, Ziekenhuis Oost-Limburg Genk, Belgium
| | - P Van Eyken
- Department of Pathological Anatomy, Ziekenhuis Oost-Limburg Genk, Belgium
| | - I Vanmoerkerke
- Department of Gastroenterology and Hepatology, Jessa Ziekenhuis Hasselt, Belgium
| | - F Janssens
- Department of Gastroenterology and Hepatology, Jessa Ziekenhuis Hasselt, Belgium
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Abstract
Hepatobiliary and pancreatic ascariasis (HPA) was described as a clinical entity from Kashmir, India in 1985. HPA is caused by invasion and migration of nematode, Ascaris lumbricoides, in to the biliary tract and pancreatic duct. Patients present with biliary colic, cholangitis, cholecystitis, hepatic abscesses and acute pancreatitis. Ascarides traverse the ducts repeatedly, get trapped and die, leading to formation of hepatolithiasis. HPA is ubiquitous in endemic regions and in Kashmir, one such region, HPA is the etiological factor for 36.7%, 23%, 14.5% and 12.5% of all biliary diseases, acute pancreatitis, liver abscesses and biliary lithiasis respectively. Ultrasonography is an excellent diagnostic tool in visualizing worms in gut lumen and ductal system. The rational treatment for HPA is to give appropriate treatment for clinical syndromes along with effective anthelmintic therapy. Endotherapy in HPA is indicated if patients continue to have symptoms on medical therapy or when worms do not move out of ductal lumen by 3 wk or die within the ducts. The worms can be removed from the ductal system in most of the patients and such patients get regression of symptoms of hepatobiliary and pancreatic disease.
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Abstract
BACKGROUND Though accumulated evidence proved that laparoscopic major hepatectomy was technically feasible, it remains a challenging procedure and is limited to highly specialized centers. Paragonimiasis is one of the most important food-borne parasitic zoonoses caused by the trematode of the genus Paragonimus. Although hepatic paragonimiasis is rare, the previous studies had investigated hepatic paragonimiasis from different perspectives. However, the safety and feasibility of laparoscopic major hepatectomy for hepatic paragonimiasis have not yet been reported in the literature. METHODS We here present 2 cases of hepatic paragonimiasis at the deep parts of the liver with treatment by laparoscopic major hepatectomy. One case is a 32-year-old male patient who was admitted to the hospital due to upper abdominal discomfort without fever for 1 month. The clinical imaging revealed that there was a lesion about 5.9 × 3.7 cm in the boundary of right anterior lobe and right posterior lobe of the liver with rim enhancement and tract-like nonenhanced areas. The other one is a 62-year-old female patient who was referred to the hospital for 1 month of right upper abdominal pain and fever. The ultrasonography showed that there was a huge hypoechoic mass (about 10.8 × 6.3 cm) in middle lobe of the liver with tract-like nonenhanced areas. Both patients were from an endemic area of paragonimiasis and the proportion of eosinophil in the second case was increased. RESULTS The preoperative diagnosis of the first case was ambiguous and the hepatic paragonimiasis was considered for the second case. The first case underwent laparoscopic extended right posterior lobe hepatectomy and the other case underwent laparoscopic extended left hemihepatectomy. Both operations went very well and the operation times for the 2 cases were 275 minutes and 310 minutes, respectively. The 2 patients' postoperative recovery was smooth without major postoperative complications (such as, bleeding, bile leakage, and liver failure). Moreover, the 2 patients were discharged on the 6th day and 7th day after surgery, respectively. The postoperative histopathological examination manifested hepatic paragonimiasis in both patients. CONCLUSION This study suggests that the laparoscopic approach may be safe and technically feasible for hepatic paragonimiasis.
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Affiliation(s)
- Fei Liu
- Department of Liver Surgery & Liver Transplantation Center
| | | | - Chuanfen Lei
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Yonggang Wei
- Department of Liver Surgery & Liver Transplantation Center
- Correspondence: Yonggang Wei, Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu 610041, Sichuan Province, China (e-mail: ); Bo Li, Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu 610041, Sichuan Province, China (e-mail: )
| | - Bo Li
- Department of Liver Surgery & Liver Transplantation Center
- Correspondence: Yonggang Wei, Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu 610041, Sichuan Province, China (e-mail: ); Bo Li, Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu 610041, Sichuan Province, China (e-mail: )
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Martins GLP, Bernardes JPG, Rovella MS, Andrade RG, Viana PCC, Herman P, Cerri GG, Menezes MR. Radiofrequency ablation for treatment of hypersplenism: A feasible therapeutic option. World J Gastroenterol 2015; 21:6391-6397. [PMID: 26034376 PMCID: PMC4445118 DOI: 10.3748/wjg.v21.i20.6391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/06/2014] [Accepted: 02/05/2015] [Indexed: 02/06/2023] Open
Abstract
We present a case of a patient with hypersplenism secondary to portal hypertension due to hepato-splenic schistosomiasis, which was accompanied by severe and refractory thrombocytopenia. We performed spleen ablation and measured the total spleen and ablated volumes with contrast-enhanced computed tomography and volumetry. No major complications occurred, thrombocytopenia was resolved, and platelet levels remained stable, which allowed for early treatment of the patient’s underlying disease. Previous work has shown that splenic radiofrequency ablation is an attractive alternative treatment for hypersplenism induced by liver cirrhosis. We aimed to contribute to the currently sparse literature evaluating the role of radiofrequency ablation (RFA) in the management of hypersplenism. We conclude that splenic RFA appears to be a viable and promising option for the treatment of hypersplenism.
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Abstract
Hepatic cysticercosis is a very rare entity; only four cases have been reported to date. High-resolution ultrasonography of the abdomen is the initial and most reliable modality for evaluation of hepatic cysticercosis. Medical therapy is the mainstay of treatment. We report a case of hepatic cysticercosis in a 28-year-old male who presented with right upper quadrant pain, fever, and jaundice. The article also describes the imaging patterns of hepatic cysticercosis based on different stages of evolution.
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Affiliation(s)
- Vikas Chaudhary
- Department of Radiodiagnosis, Employees' State Insurance Corporation (ESIC) Model Hospital, Sector-9A, Gurgaon, 122001, Haryana, India,
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Ye S, Wang WL, Zhao K. F-18 FDG hypermetabolism in mass-forming focal pancreatitis and old hepatic schistosomiasis with granulomatous inflammation misdiagnosed by PET/CT imaging. Int J Clin Exp Pathol 2014; 7:6339-6344. [PMID: 25337288 PMCID: PMC4203259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 08/23/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE We report the case of a 59-year-old male patient who presented with space-occupying lesions in the pancreas and liver suggestive of metastatic pancreatic cancer. MATERIALS AND METHODS Whole-body F-18 fluorodeoxyglucose (FDG) PET/CT imaging and enhanced CT imaging of the lesions were performed in addition to abdominal ultrasound, ERCP, and MRCP. Tumor markers, including CA199 and AFP, were also evaluated. RESULTS PET/CT imaging showed a soft tissue mass with indistinct boundaries in the head of the pancreas with a maximum SUV of 4.39. A less dense shadow was also found in the left lobe of the liver with an indistinct boundary and a maximum SUV of 4.13. Enhanced CT revealed an enhancing mass in the head of the pancreas on arterial phase imaging as well as a mildly enhancing focus in the left lobe of the liver. The patient was diagnosed with a space-occupying lesion of the uncinate process of the pancreas suggestive of pancreatic cancer with metastasis to the liver. However, serum tumor markers were normal. Postoperative pathology was consistent with chronic pancreatitis and old hepatic schistosomiasis associated with granulomatous inflammation of the liver. CONCLUSION This case of mass-forming pancreatitis and granulomatous inflammation in old hepatic schistosomiasis mimicked metastatic pancreatic cancer on PET/CT. Such false positive lesions have not been reported before, and further exploration and investigation are needed.
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Affiliation(s)
- Song Ye
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityZhejiang 310003, China
| | - Wei-Lin Wang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityZhejiang 310003, China
| | - Kui Zhao
- Department of PET/CT Center, The First Affiliated Hospital, College of Medicine, Zhejiang UniversityZhejiang 310003, China
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zhao H, Feng D. [Live paragonimiasis as liver cancer with multiple abdominal metastases: a case report]. Zhonghua Gan Zang Bing Za Zhi 2014; 22:309-310. [PMID: 25199209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Deady B, Pullen B, Hodges D. There will be an answer; let it bleed. CAN J EMERG MED 2014; 16:160-3. [PMID: 24626123 DOI: 10.2310/8000.2013.131026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Chandra TJ, Dash S, Srinivas G, Rao PVP. Hepatopleuropulmonary amoebiasis--a case report. J Indian Med Assoc 2013; 111:348. [PMID: 24765700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Amoebiasis is a food-borne protozoan infection, caused by Entamoeba histolytica. Here a case of hepatopleuropulmonary amoebiasis, which was detected after fibre-optic bronchoscopy is reported. Bronchial aspirate showed trophozoites of Entamoeba histolytica. The patient was treated with tinidazole and responded favourably.
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Abstract
Liver disease is an important source of morbidity among ill returning travelers. Jaundice is one of the most common and obvious symptoms of liver disease, the differential diagnosis of which is extensive, especially in travelers. Jaundice in travelers can arise from both infectious and noninfectious causes. We herein summarize the most common parasitic etiologies that may lead to jaundice in the returned traveler, visitors of friends and relatives, or new immigrants, and describe the etiology, epidemiology, and pathogenesis of clinical features of each.
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Affiliation(s)
- Wilson W Chan
- Calgary Laboratory Services, Calgary, Alberta, Canada
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Kristensen AD, Achiam M. [Coincidental finding of biliary ascariasis]. Ugeskr Laeger 2010; 172:1213-1214. [PMID: 20423666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
We describe a case of biliary ascariasis in a 27-year-old Philippine au-pair with recurrent upper abdominal pain. Hepatobiliary ascariasis is rarely seen in non-endemic areas. The diagnosis is important because severe complications can occur. If migrated into the biliary tree, it is recommended to perform endoscopic extraction combined with antihelmintic therapy. In severe cases, the recommendation is laparoscopic cholecystectomy and peroperative exploration of the common hepatic duct.
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Ota KV, Dimaras H, Héon E, Gallie BL, Chan HSL. Radiologic surveillance for retinoblastoma metastases unexpectedly showed disseminated toxocariasis in liver, lung, and spinal cord. Can J Ophthalmol 2010; 45:185-6. [PMID: 20379316 DOI: 10.3129/i09-216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Affiliation(s)
- Silvio Pampiglione
- Department of Veterinary Public Health and Animal Pathology, University of Bologna, Italy
| | - Andrea Gustinelli
- Department of Veterinary Public Health and Animal Pathology, University of Bologna, Italy
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Baños Madrid R, Alemán Lorca F, Serrano Jiménez A, Alajarín Cervera M, Alberca de Las Parras F, Molina Martínez J, Carballo Alvárez F. [Rectal and liver involvement in schistosomiasis]. Rev Esp Enferm Dig 2008; 100:62-64. [PMID: 18358067 DOI: 10.4321/s1130-01082008000100017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Kabaalioglu A, Ceken K, Alimoglu E, Saba R, Cubuk M, Arslan G, Apaydin A. Hepatobiliary Fascioliasis: Sonographic and CT Findings in 87 Patients During the Initial Phase and Long-Term Follow-Up. AJR Am J Roentgenol 2007; 189:824-8. [PMID: 17885052 DOI: 10.2214/ajr.07.2127] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of our study was to describe the initial and long-term imaging findings in hepatobiliary fascioliasis. CONCLUSION Most patients with fascioliasis have typical hepatobiliary imaging findings. It is important to know that residual fibrotic or necrotic foci may remain for years after cure. Long-term complications are rare in fascioliasis, and malignancy or cirrhosis related to the disease has not been observed.
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Affiliation(s)
- Adnan Kabaalioglu
- Department of Radiology, Akdeniz University Hospital, Dumlupinar Cad. 07059, Antalya, Turkey.
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Nabi F, Palaha HK, Sekhsaria D, Chiatale A. Capillaria hepatica infestation. Indian Pediatr 2007; 44:781-782. [PMID: 17998580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Capillaria hepatica is a very rare zoonotic infestation which primarily infests rodents and is rarely found in humans. The presenting features are fever of unknown origin, hepatomegaly and peripheral eosinophilia. Liver biopsy remains the cornerstone of diagnosis. Treatment of choice is Albendazole and outcome is generally good.
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Affiliation(s)
- Fazal Nabi
- Department of Pediatrics and Histopathology, Jaslok Hospital and Research Center, 15 Dr. G Deshmukh Marg, Mumbai, India
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25
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Medeiros FSD, Tavares-Neto J, D'Oliveira A, Paraná R. [Liver injury in visceral leishmaniasis in children: systematic review]. Acta Gastroenterol Latinoam 2007; 37:150-157. [PMID: 17955725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
UNLABELLED Visceral Leisshimaniosis or Kalazar is a parasitic infection caused by Leishimania Donovani subspecies. It is transmitted by phlebotomineos and may lead to liver and spleen enlargements as well as immunological impairment. Sometimes it is described liver injury simulating acute or chronic viral hepatitis and even portal hypertension. The liver injury makes difficult the diffencial diagnosis of Kalazar and other liver diseases in endemic regions. OBJECTIVE To define and clarify the liver injury spectrum described in published cases reports. METHODS Systematic revision of published data on Kalazar and liver injury using the following databank: LILACS, MEDLINE and EMBASE. Only paper published in French, English, Portuguese and Spanish were taken into consideration. The procedures for systematic review recommended by the NHS Centre for Reviews and Dissemination, University of Cork, were adopted. The paper quality classification was based on the number of reported variables previously defined in our study RESULTS Only 11/28 (55%) publications were included in our analysis because they filled the minimal required data. Acute and chronic liver disease were well documented in these articles. Serum albumin and prothombine time were associated with severity of liver disease (P < .05). CONCLUSION "Liver involvement, even when it is severe, may occur at tha begining of the disease. Kalazar should be considered as a differential diagnosis of cholestasis, acute and chronic liver injury as well as portal hypertension in children.
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Gétaz L, Chappuis F, Loutan L. [Intestinal and hepatic parasitic diseases: diagnosis and treatment]. Rev Med Suisse 2007; 3:1254-8. [PMID: 17585630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Intestinal parasites represent an important burden of disease mainly in developing countries. Physicians practicing in Europe can be exposed to these diseases, mainly seen in immigrants or travellers returning from tropical countries. Several parasitic diseases remain ubiquitous and can be contracted in developed countries. Most often, parasitic infections cause no or only few symptoms, but some can lead to serious disease in immuno-compromised patients. Diagnostic procedures and treatments available are discussed.
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Affiliation(s)
- L Gétaz
- Unité de médecine des voyages et des migrations HUG, 1211 Genève 14
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Abstract
The acquired immunodeficiency syndrome is now the leading cause of death in the world. Liver involvement in opportunistic infections and neoplasms affecting patients with human immunodeficiency disease syndrome are common. Many of these patients also take many medicines and toxins that are potentially harmful to the liver. This is an overview on the aetiology and possible diagnostic guide to determine liver involvement in patients with HIV infection. A literature review was performed on major published series on the liver and HIV infection between 1985 and 1999, both years inclusive. Data and opinions from 5 general reviews and 31 original articles from MEDLINE on liver disease in patients with HIV infection regarding aetiology, pathology, presentation and patient evaluation are summarised. The liver is frequently affected in patients with AIDS. The majority of the patients have hepatomegaly and abnormal liver enzymes secondary to involvement with opportunities infections, AIDS associated neoplasms and drug therapy. Most of the infections reach the liver by lymphohaematogeneous spread from other sites in the body. Methodical approach in patient evaluation is therefore essential for prompt diagnosis and treatment to minimise morbidity and early mortality.
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Affiliation(s)
- Hudson Lodenyo
- Centre for Clinical Research, Department of Gastroenterology, Chris Hani Baragwanath Hospital, P O Bertsham 2013, Johannesburg, South Africa
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Bezerra ASA, D'Ippolito G, Caldana RP, Cecin AO, Ahmed M, Szejnfeld J. Chronic hepatosplenic schistosomiasis mansoni: magnetic resonance imaging and magnetic resonance angiography findings. Acta Radiol 2007; 48:125-34. [PMID: 17354130 DOI: 10.1080/02841850601105833] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE To evaluate the hepatosplenic manifestations and the portal venous system in patients with chronic infection by Schistosoma mansoni. MATERIAL AND METHODS A cross-sectional observational study was performed in 28 patients with chronic hepatosplenic schistosomiasis submitted to magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) of the abdomen. Images were interpreted independently by two radiologists to determine the reproducibility of image interpretation and who evaluated the presence of morphological alterations in the liver and spleen, such as hepatosplenomegaly, hepatic fissure widening, periportal fibrosis, and the presence of siderotic nodules. Interobserver and intra-observer agreement were measured with the kappa and intraclass correlation tests. Evaluation of venous collateral pathways and portal and splenic veins was done in consensus by both examiners. RESULTS Observers identified enlargement of the left lobe (78.5-92.8%) and caudate-to-right-lobe ratio (78.5-92.8%), irregularity of hepatic contours (89.2-96.4%), fissure widening (89.2-100%), and splenic siderotic nodules (84.2%). Splenomegaly, heterogeneity of hepatic parenchyma, peripheral hepatic vessels, and periportal fibrosis were observed in 100% of patients. MRI findings presented almost perfect interobserver (kappa = 0.65-1) and intra-observer (kappa = 0.73-1 for observer 1, and kappa = 0.65-1 for observer 2) agreement for the variables analyzed. MRA showed the presence of collateral pathways in the majority of patients (71.4%) along with widening of portal and splenic veins. CONCLUSION Using MRI, hepatosplenic alterations in schistosomiasis are characterized by heterogeneity of hepatic parenchyma, presence of peripheral perihepatic vessels, periportal fibrosis, splenomegaly, siderotic nodules, and the presence of venous collateral pathways.
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Affiliation(s)
- A S A Bezerra
- Department of Diagnostic Imaging, Federal University of São Paulo, São Paulo, Brazil
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Abstract
Schistosomiasis was diagnosed in two Portuguese soldiers who had been deployed to Portuguese colonies in Africa. The first veteran was diagnosed as having schistosomiasis 34 years after returning from Angola, and the second veteran was found with Schistosoma haematobium infection 40 years after returning from Mozambique. The patient with Schistosoma mansoni had an active infection, because eggs were recovered with living miracidia. The second patient had developed urothelial cancer, but eggs recovered were calcified.
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Affiliation(s)
- Paulo Vieira
- Center of Parasite Immunology and Biology, National Institutes of Health, Porto, Portugal
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30
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Abstract
Visceral leishmaniasis is a life-threatening infection due to Leishmania parasites that has been reported in 62 countries. The Mediterranean area is endemic for Leishmania infantum and cases have been reported in Spain, France, Italy and Portugal. During the infection, parasites disseminate in the phagocyte cells of bone marrow, the spleen, liver and lymph nodes. In this paper, we review the clinical and biological signs observed in visceral cases of leishmaniasis with hepatic involvement. We also focus on experimental and pathophysiological data to clarify our understanding of liver involvement during this infection.
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Affiliation(s)
- Jean-Pierre Gangneux
- Laboratoire de Parasitologie-Mycologie, Faculté de Médecine, CHU de Rennes, 2 rue du Pr. Léon Bernard, 35043 Rennes Cedex, France.
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Mahesh Kumar J, Reddy PL, Aparna V, Srinivas G, Nagarajan P, Venkatesan R, Sreekumar C, Sesikaran B. Strobilocercus fasciolaris infection with hepatic sarcoma and gastroenteropathy in a Wistar colony. Vet Parasitol 2006; 141:362-7. [PMID: 16842924 DOI: 10.1016/j.vetpar.2006.05.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2006] [Revised: 05/06/2006] [Accepted: 05/29/2006] [Indexed: 11/26/2022]
Abstract
Tapeworm cysts were identified in liver of Wistar rats and it induced fibrosarcoma in liver and gastroenteropathy in stomach and intestine. The tapeworm larva was confirmed as Strobilocercus fasciolaris by PCR linked mitochondrial DNA sequencing. Light microscopy, special staining (masson trichrome) and immunoflouresence supported the diagnosis of fibrosarcoma. Infiltration of plasma cells, macrophages and eosinophils were observed in the liver section. Gastric mucosal hyperplasia, dilation of gastric glands with secretion, intestinal mucosal cell hyperplasia, proliferation of duodenal submucosal glands were confirmed by light microscopy and supported by PAS, AB staining. The concomitant development of hepatic sarcoma and gastroenteropathy by larvae of Taenia taeniaeformis (S. fasciolaris) infection is very rare and is the first reported case in Wistar rats to our knowledge.
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Affiliation(s)
- J Mahesh Kumar
- Animal House, Centre For Cellular and Molecular Biology, Uppal Road, Hyderabad 500 007, India.
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MESH Headings
- Amyloidosis/diagnosis
- Amyloidosis/pathology
- Autoimmune Diseases/diagnosis
- Autoimmune Diseases/pathology
- Biopsy
- Humans
- Hyperplasia
- Hypertension, Portal/diagnosis
- Hypertension, Portal/etiology
- Hypertension, Portal/pathology
- Hypertension, Portal/therapy
- Liver/blood supply
- Liver/pathology
- Liver Circulation
- Liver Cirrhosis, Biliary/diagnosis
- Liver Cirrhosis, Biliary/pathology
- Liver Diseases/congenital
- Liver Diseases/diagnosis
- Liver Diseases/pathology
- Liver Diseases/physiopathology
- Liver Diseases, Parasitic/diagnosis
- Liver Diseases, Parasitic/pathology
- Microcirculation
- Sarcoidosis/diagnosis
- Sarcoidosis/pathology
- Schistosomiasis/diagnosis
- Schistosomiasis/pathology
- Tuberculosis, Hepatic/diagnosis
- Tuberculosis, Hepatic/pathology
- Venules/pathology
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Affiliation(s)
- Sophie Hillaire
- Réseau Val de Seine, Hôpital Foch, Suresnes Hôpital Beaujon, Clichy
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33
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Marinho CC, Voieta I, Azeredo LM, Nishi MP, Batista TS, Pereira ACF, Serufo JC, Queiroz LCD, Ruiz-Guevara R, Antunes CM, Prata A, Lambertucci JR. Clinical versus ultrasound examination in the evaluation of hepatosplenic schistosomiasis mansoni in endemic areas. Mem Inst Oswaldo Cruz 2006; 101 Suppl 1:317-21. [PMID: 17308789 DOI: 10.1590/s0074-02762006000900050] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Accepted: 06/26/2006] [Indexed: 11/22/2022] Open
Abstract
The best way to appraise the size of abdominal organs remains undefined. Herein we compare the size of liver and spleen in hepatosplenic schistosomiasis using clinical and ultrasound (US) examination, and the size of the organs measured by US with their visualization below the costal margin ("palpable by US"). For this study, 411 individuals from an endemic area for schistosomiasis mansoni in Brazil have been selected. We found that palpable spleens and left liver lobes are larger than non palpable ones. Also, 23% of normal spleens measured by US were palpable on clinical examination, and 22% of spleens increased in size on US were non palpable. A total of 21% of normal spleens were "palpable by US". We also found 54% of normal sized right liver lobes palpable on clinical examination, whilst 54% of the increased livers, measured by US, were non palpable. About 76% of normal right liver lobes were "palpable by US". We conclude that the association of clinical, ultrasound and magnetic resonance imaging (MRI) examinations, in the near future, should give the investigators the necessary tools to perform a more accurate clinical diagnosis of hepatosplenic schistosomiasis mansoni.
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Affiliation(s)
- Carolina Coimbra Marinho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, 30130-100 Belo Horizonte, MG, Brazil
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34
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Zhang WC, Mao YF. [Re-understanding of liver cirrhosis induced by Schistosomiasis japonica]. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi 2006; 24:382-4. [PMID: 17361823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Whether the hepatic pipestem fibrosis induced by schistosomiasis japonica can result in cirrhosis, confusion exists among parasitologists in China. Evidence from national and international pathologists and clinicians confirmed that the pipestem fibrosis could develop into cirrhosis undoubtedly. Owing to different pathogenic causes, the characters of cirrhosis are different. To re-understand cirrhosis induced by Schistosomiasis japonica is of significance for the diagnosis and treatment of the advanced patient.
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Affiliation(s)
- Wu-cheng Zhang
- Department of Pathogenic Biology, Medical School, Zhejiang University, Hangzhou 310031, China
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35
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Affiliation(s)
- Alice Yao
- University of Iowa College of Medicine Iowa City, IA 52242, USA
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36
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Abstract
BACKGROUND The differential diagnoses of a circumscribed mass of the liver are varied. Especially if a malignant tumor, capable of setting metastases to the liver, is known in a patient's medical history, there might be difficulties in differentiating the tumor's entity. CASUISTRY: We report a case of a 40-year-old male with a history of malignant melanoma in whom follow-up investigations revealed a mass in the liver. RESULTS The histopathological and microbiological results, however, showed an infestation of liver tissue with nematodes. Malignant tumor cells could not be detected. CONCLUSIONS Roundworm-infections of the liver can present as lesions suspicious of being malignant. Therefore, along with e.g. microhamartoma, microabscesses and hepatocellular carcinoma, infestation with nematodes should be taken into consideration.
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Affiliation(s)
- M Maier
- Department of Surgery, University of Würzburg, Würzburg, Germany
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37
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Abstract
Pentastomiasis is a rare zoonotic disease. Almost all recorded cases of human pentastomiasis had been incidental findings at autopsy. We report an unusual case of human pentastomiasis mimicking liver tumor successfully treated by liver resection. This clinical presentation is uncommon and it was probably caused by a pentastomid that exited its cyst and migrated to the liver causing an infarct that was mistaken as a primary liver tumor. Diagnosis could not be made before the surgery. This is the first reported case of human pentastomiasis in Brazil.
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38
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Yildirim A, Iça A, Beyaz L, Atasaver A. [Acute hepatitis cysticercosa and pneumonitis cysticercosa in a lamb: case report]. Turkiye Parazitol Derg 2006; 30:108-11. [PMID: 17124659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The diseases known as hepatitis cysticercosa and pneumonitis cysticercosa are caused by migrating Cysticercus tenuicollis, the intermediate stage of Taenia hydatigena, in the liver and lung tissue of intermediate hosts like sheep, goats, cattle, pigs and squirrels. In this study, parasitological and pathological examinations were performed on the liver and lung tissue samples of a one month old lamb that had died in a herd of Karadayi village, Bünyan, Kayseri. After the examination, hepatitis cysticercosa and parasitic verminous pneumonia (Pneumonitis cysticercosa) were diagnosed and the results were discussed.
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Affiliation(s)
- Alparslan Yildirim
- Erciyes Universitesi, Veteriner Fakültesi, Parazitoloji Anabilim Dali, Kayseri.
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Abstract
AIM To determine whether liver biopsy might be useful in the diagnosis of visceral leishmaniasis when bone marrow examination and serologic tests are inconclusive. METHODS Over a 10-year period, liver biopsy was performed in five children with suspected visceral leishmaniasis when indirect hemagglutination tests and bone marrow aspirations were not diagnostic. RESULTS Leishmania amastigotes were seen in Kupffer cells in all patients. The accompanying liver histopathological findings were ischemic necrosis in two children, macrovesicular steatosis in two children, portal inflammatory inflammation in two children, and piecemeal necrosis in one child. During the study period, 32 additional pediatric visceral leishmaniasis cases were diagnosed by bone marrow examination. CONCLUSION Liver biopsy can be recommended for diagnosing suspected visceral leishmaniasis in children when serology and bone marrow aspiration are inconclusive.
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Affiliation(s)
- Reha Artan
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Akdeniz University School of Medicine, Antalya, Turkey.
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40
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Abstract
Blood hypereosinophilia (eosinophilia count of more than 500 per microliter, i.e., 0.5.10(9)/L) is a laboratory finding that requires a careful workup. Review of the patient's medical history and clinical examination can usually rule out non-parasitic causes. Parasitic infections must be sought by examination of stool, urine, and blood examinations and by serological tests. These examinations, with special techniques for cosmopolitan and tropical parasites and for digestive or tissular parasites, must be repeated. Improvement of blood eosinophilia and of the serum antibody titers is one criterion of treatment effectiveness.
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MESH Headings
- Antiparasitic Agents/administration & dosage
- Antiparasitic Agents/therapeutic use
- Diagnosis, Differential
- Eosinophilia/diagnosis
- Eosinophilia/etiology
- Eosinophilia/parasitology
- Food Parasitology
- Helminthiasis/complications
- Helminthiasis/diagnosis
- Helminthiasis/drug therapy
- Helminthiasis/parasitology
- Humans
- Intestinal Diseases, Parasitic/complications
- Intestinal Diseases, Parasitic/diagnosis
- Intestinal Diseases, Parasitic/drug therapy
- Intestinal Diseases, Parasitic/parasitology
- Liver Diseases, Parasitic/complications
- Liver Diseases, Parasitic/diagnosis
- Liver Diseases, Parasitic/drug therapy
- Liver Diseases, Parasitic/parasitology
- Lung Diseases, Parasitic/complications
- Lung Diseases, Parasitic/diagnosis
- Lung Diseases, Parasitic/drug therapy
- Lung Diseases, Parasitic/parasitology
- Medical History Taking
- Parasitic Diseases/complications
- Parasitic Diseases/diagnosis
- Parasitic Diseases/drug therapy
- Parasitic Diseases/etiology
- Parasitic Diseases/parasitology
- Parasitic Diseases/therapy
- Schistosomiasis/complications
- Schistosomiasis/diagnosis
- Schistosomiasis/drug therapy
- Schistosomiasis/parasitology
- Time Factors
- Travel
- Tropical Climate
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Affiliation(s)
- Patrice Bourée
- Service de parasitologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
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41
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Göksu T, Junghanss T. Der Wurm in der Leber. Therapeutische Umschau 2005; 62:787-92. [PMID: 16350543 DOI: 10.1024/0040-5930.62.11.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Patienten mit parasitär bedingten Leberleiden stellen in den meisten europäischen Ländern ein sehr kleines Kollektiv dar. Sie werden in der Differentialdiagnose von hepatischen Raumforderungen, Leberparenchymveränderungen, Schmerzen im rechten Oberbauch, Cholestase oder Transaminasenerhöhung, wenn überhaupt, meist zuletzt in Betracht gezogen. Den meisten Gesundheitseinrichtungen mangelt es an diagnostischer und therapeutischer Erfahrung. Diese Erkrankungen sind in spezialisierten Zentren (dies sind traditionsgemäß meist tropenmedizinische Einrichtungen) am besten aufgehoben. Wichtige Komponenten bei der Abklärung sind: Risikoanamnese (Herkunft, Reisen, Exposition), die geographische Verbreitung der Parasitosen, Inkubations- und Präpatenzzeit, Labor (Eosinophilie, IgE-Erhöhung, direkter Parasitennachweis, Serologie), sowie bildgebende Verfahren. Es werden die wichtigsten Parasitosen der Leber dargestellt: Schistosomiasis, Echinokokkose, Faszioliasis, Toxocariasis.
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Affiliation(s)
- T Göksu
- Sektion Klinische Tropenmedizin, Universitätsklinikum Heidelberg, Heidelberg.
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42
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Abstract
Visceral larva migrans (VLM) most commonly occurs as a febrile disease of childhood particularly affecting children between 1 and 7 years of age. Pulmonary, dermatological, hepatic, lymphatic, cardiac, rheumatological and neurological manifestations may occur. VLM seems to be a rare disease in adults. We report the imaging findings of a woman with hepatic toxocariasis. Ultrasonography showed a solitary hepatic lesion measuring 4 x 3 cm, displaying a hypoechoic-heterogeneous pattern with ill-defined borders and distal acoustic enhancement, located in the right sub-diaphragmatic area. Two enlarged periportal lymph nodes and moderately dilated intrahepatic biliary ducts were also noted. The probability of toxocariasis was discussed, based on sonographic and biopsy findings, and the final diagnosis was confirmed by a specific ELISA test. In summary, a clinical picture of cholestasis initially resembling hepatitis or malignancy should be further evaluated by imaging techniques, and the ultrasound examiner should be familiar with the possible findings of hepatic toxocariasis, which consist of focal ill-defined hepatic lesions, hepato-splenomegaly, biliary dilatation, sludge and periportal lymph node enlargement.
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Affiliation(s)
- A Kabaalioğlu
- Department of Radiology, Akdeniz University Faculty of Medicine, Turkey.
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43
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Kim YH, Kang KJ, Kwon JH. [Four cases of hepatic fascioliasis mimicking cholangiocarcinoma]. Korean J Hepatol 2005; 11:169-75. [PMID: 15980676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Human fascioliasis is a zoonosis caused by Fasciola hepatica, and this is a trematode that infests cattle and sheep. Humans are accidental hosts in the life cycle of this parasite. People are infected by ingestion of the water or the raw aquatic vegetables that are contaminated with the metacercaria. This fluke's worldwide distribution occurs in areas where sheep, cattle and goats are raised, and there is a life-cycle niche for this fluke in lymnaeid snails. However, it is a rare disease in Korea. We experienced four human fascioliasis which were difficult to differentiate from hepatic malignancy in three patients, and this was misdiagnosed as common hepatic duct tumor in one patient. The patients manifested only vague abdominal symptoms. Intrahepatic fascioliasis showed multiple ill-defined hypoattenuating lesions and filling defects of the lesion lumens on radiologic study. A striking eosinophilia from the patients' blood was identified and a positive finding of a serum enzyme linked immunosorbent assay for the Fasciola hepatica was also noted in three of four patients. The therapeutic trial with triclabendazole and praziquantel was not successful.
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Affiliation(s)
- Yong Hoon Kim
- Department of Surgery, Keimyung University School of Medicine, Daegu, Korea.
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Klenzak J, Mattia A, Valenti A, Goldberg J. Hepatic capillariasis in Maine presenting as a hepatic mass. Am J Trop Med Hyg 2005; 72:651-3. [PMID: 15891145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
We report the first case of hepatic capillariasis in Maine. The patient was a 54-year-old male carpenter who presented with a subacute history of severe abdominal pain, fevers, and weight loss. Initial diagnostic studies suggested a hepatic mass associated with para-aortic lymphadenopathy. The patient underwent open laparotomy for resection of the mass. He was found to have an eosinophilic granuloma in the liver; further evaluation revealed degenerating Capillaria hepatica. The exact route of infection in this case is unknown but is most likely due to accidental ingestion of soil contaminated with mature capillaria eggs. This patient had a low parasite burden and did not exhibit significant peripheral eosinophilia. After treatment with thiabendazole, he recovered uneventfully.
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Affiliation(s)
- Jennifer Klenzak
- Division of Nephrology, Department of Medicine, Maine Medical Center, Portland, Maine 04102, USA.
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45
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Abstract
Insulin-like growth factors (IGFs) play an important role in cell growth and differentiation, and the liver is the main source of IGFs and IGF-binding proteins (IGFBPs) that appear in the circulation. The effect of liver cysts on the circulating IGF system was studied in this work. Serum concentrations of IGF-I and -II were measured by radioimmunoassay, IGFBP patterns were characterised by ligand-affinity and immunoblotting, and a lectin-binding assay was used to investigate the glyco component of IGFBP-3 complexes. IGF-I and -II concentrations in patients with cysts were significantly lower compared to those in healthy individuals (P<0.0001 and P<0.01, respectively), and the decrease was related to age but not sex. The overall mean concentrations of IGF-I and -II were not significantly different whether the cysts were caused by Echinococcus granulosus, cross-reactive pathologies, or some other factor. IGFBP profiles correlated with the amount of IGF present: patients with lower IGF-I concentrations expressed decreased IGFBP-3 and elevated IGFBP-2 levels. Increased IGFBP-3 proteolytic activity in the patients' blood was not detected by immunoblotting. In the lectin-binding assay, IGFBP-3 complexes in the circulation of patients demonstrated reactivity similar to that in healthy persons, suggesting that the overall structure of the saccharide moieties of the IGFBP-3 complexes was not significantly altered due to liver cyst formation.
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Affiliation(s)
- Olgica Nedić
- Institute for the Application of Nuclear Energy (INEP), Banatska 31b, 11080 Belgrade-Zemun, Serbia and Montenegro.
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Abstract
OBJECTIVE This study describes the findings of magnetic resonance imaging (MRI) of focal eosinophilic infiltration of the liver. METHODS Contrast-enhanced MR images of 8 patients with focal hepatic eosinophilic infiltration were reviewed retrospectively. We evaluated the signal intensity of focal lesions in T1-weighted and T2-weighted images and the pattern of enhancement in a dynamic contrast study. RESULTS A total 22 focal hepatic lesions were observed; the lesions were isointense (55%) or hypointense (45%) on T1-weighted images and isointense (14%) or hyperintense (86%) on T2-weighted images. The arterial phase of the contrast study revealed 11 hyperintense lesions (50%). During the portal and delayed phases, 18 (82%) and 17 lesions (77%) were hyperintense, respectively. CONCLUSION The focal eosinophilic infiltrations showed homogeneous enhancement in the portal and delayed phases in the dynamic contrast MR study. These findings should help to distinguish focal eosinophilic infiltration, especially from metastasis in patients with malignancy.
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Affiliation(s)
- Joo Sung Sun
- Department of Diagnostic Radiology, Ajou University, College of Medicine, Kyunggido, Korea
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Magalhães TVB, Gazzinelli G, Alvarez MCB, Lima e Silva FC, Fraga LAO, Silveira AMS, Gazzinelli A, Bethony J, LoVerde P, Caldas IR, Correa-Oliveira R, Prata A. Comparative clinical and ultrasound study of egg-negative and egg-positive individuals from Schistosoma mansoni low morbidity endemic areas, and hospitalized patients with hepatosplenic disease. Rev Soc Bras Med Trop 2005; 38:33-7. [PMID: 15717092 DOI: 10.1590/s0037-86822005000100007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Two hundred and twenty three subjects from a Schistosoma mansoni low morbidity endemic area and nine hospitalized hepatosplenic patients were submitted to stool test and clinical examination and abdomen ultrasound assessments. According to stool examination and ultrasound results, they were grouped as follows: G1 -- 63 Schistosoma mansoni egg-negative individuals; G2 -- 141 egg-positive patients and without evidence of periportal fibrosis; G3 -- 19 egg-positive patients with periportal echogenicity (3-6 mm); and G4 -- 9 hepatosplenic patients with periportal echogenicity (> 6 mm). Hepatomegaly detected by physical examination of the abdomen evaluated in the midclavicular line was verified in G1, G2 and G3, respectively, in 11.1, 12.1 and 26.3%. In G1, G2 and G3, periportal thickening occurred only in schistosomal patients (8.5%). Mild pathological alterations in patients that cannot yet be detected by clinical examination were detectable in the liver by ultrasound and can be due to fibrosis. The degree of mild periportal fibrosis was diminished in 57.9% of patients 12 months after treatment of schistosomiasis with oxamniquine. At ultrasonography, the mean liver left lobe measurement of G3 was larger than that of G1, and that of G4 larger than that of G1 and G2. The mean size of the spleen of G4 was significantly larger than that of the other three groups, and that of G3 larger than that of G1 and G2.
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Abstract
Human helminthic infestation is exceedingly common on a global scale, with as many as 1.5 to 2 billion people affected worldwide. Helminths (parasitic worms) that infect the liver and hepatobiliary system include nematodes (roundworms), cestodes (tapeworms), and trematodes (flatworms or flukes). The majority of morbidity and mortality from these infestations is caused by the host immune response to the larvae or adult worm. Helminthic disease manifestations vary from the extremes of asymptomatic carriage to cirrhosis and decompensated liver disease. Current basic science and clinical research focus on improvements in medical therapy, mass screening and chemoprophylaxis, and the development of preventative vaccine strategies.
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Affiliation(s)
- Paul J Pockros
- Division of Gastroenterology/Hepatology, Liver Research Consortium, Scripps Clinic, 10666 North Torrey Pines Road, La Jolla, CA 92037, USA.
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Abstract
We report a case of a ciliated hepatic foregut cyst (CHFC) in the left lobe of the liver in a 42-year-old woman. To date, only 60 cases of these respiratory epithelial lined hepatic cysts have been reported since first described by Friedrich in 1857. CHFC are believed to be congenitally derived from the embryonic foregut and are considered benign lesions that are most often unilocular. Recently, however, there has been documented malignant transformation in these cysts. The majority of patients with a CHFC are asymptomatic and the cyst is usually an incidental finding during abdominal imaging studies or during surgical exploration. Interestingly, 85% of the total number of cases of CHFC have been reported within the last two decades. This recent rise in case reports is likely explained by greater detection because of the dramatic rise in the use of abdominal imaging. In our case, however, ultrasound failed to demonstrate any lesion within the liver and on computed tomography the cyst was more consistent with a soft tissue mass. Therefore, pathologic evaluation was necessary for the correct diagnosis of this liver lesion and to exclude malignancy.
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Affiliation(s)
- Joseph D Jakowski
- Department of Pathology, The Ohio State University, Columbus, OH 43210, USA
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Affiliation(s)
- Dominique A Vuitton
- Université de Franche-Comté, Centre Collaborateur de l'OMS pour la prévention et le traitement des échinococcoses humaines
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