HISTOPATHOLOGICAL STUDY ON HYDATIDOSIS
H.A. Dawoud1, Manal Z Abdel-Lalif2, Khairy A Hassan3, Mahmoud Addel-Azezz4, Mostafa M Abu-zeid5
Departments of Parasitology1,2,3, Tropical medicine4, Gastroenterology Surgical Center5, Faculties of Medicine1,2,3,4,5, Suez Canal1, Menia2,Al azhar3, Mansoura4,5 Universities, Egypt
Background: Cystic echinococcosis (cystic hydatid disease) is clinically related to the presence of one or more well-delineated spherical primary cysts, most frequently formed in the liver, and then in the lungs and other organs such as kidney, spleen, brain, heart and bone. Clinical manifestations are primarily determined by the site, size and number of the cysts, and are therefore highly variable. In many cases diagnosis can be made by various imaging techniques, including US, CT, X-ray and MRI. These imaging techniques are highly sensitive but not specific for the diagnosis of unilocular hepatic echinococcal cyst without awaiting the results of serological tests. A firm diagnosis can be made of histopathological examination. Early diagnosis of the disease is essential for prevention of its complication which often need intensive care management. Objectives: This work aimed to study the histopathological changes in the organ affected with hydatid cyst. Subjects and Methods: The studied group included 30 proven hydatidosis patients confirmed by: Clinical examination, imaging study and laboratory investigation in the form of complete blood picture, sputum examination, detection of antibodies against E. granulosus using two serological methods: IHA and ELISA. Results: Histopathological examination revealed that liver tissue showed focal graunlomatous reaction formed of round cell infiltration, large aggregates of foamy histiocytes, congested blood capillaries, neutrophils, eosenophils and fibroblasts. Examination of lung specimens revealed that the adjacent lung tissue is congested, compressed with atelectasis and showed irreversible inflammatory changes in the form of bronchiectasis and interstitial sclerosis. Examination of the splenic specimens revealed that the surrounding splenic tissue shows signs of pressure atrophy, congested blood vessels and areas of hyalinization Conclusion: Hydatidosis has proved to be a great worldwide health problem. This disease should be suspected in cystic lesions affecting any organ in the body, especially in endemic areas of the world. A high index of suspicion in non-endemic areas with the use of diagnostic tools especially imaging and serological techniques leads to early diagnosis of the disease, confirmation of diagnosis is achieved by histopathological examination of cysts after their surgical removal.
December 2011