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Liver and intrahepatic bile ducts-nontumor

Infectious (non-viral) disorders

Fasciola hepatica (liver fluke)


Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 8 June 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.

General
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● Common liver fluke or sheep liver fluke; parasitic flatworm of class Trematoda, phylum Platyhelminthes; infects livers of various mammals, including humans (Wikipedia)
● Occurs in Southeast Asia and other locations where population consumes watercress or other freshwater plants containing metacercariae (Gastroenterol Clin North Am 1996;25:627)
● Usually produces lesions in liver, rarely gallbladder and stomach
● Parasite penetrates hepatic capsule, migrates into bile ducts causing necrosis, scarring and eosinophilic granulomas
Diagnosis: operculated eggs in stool, duodenal or biliary drainage; immunodiagnostic testing

Diagrams
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Life cycle

Clinical images
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Eggs


Cercaria

       
Adult worms

Gross description
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● Solitary or multiple surface yellow nodules, 5-20 mm, resembling metastases
● Cut sections show tracks ending at subcapsular cavities filled with necrotic material

Case reports
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● 65 year old woman with right upper quadrant discomfort (J Radiol Case Rep 2010;4:13)

Micro description
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● Dilated intrahepatic bile ducts contain adult flukes, necrotic debris, eosinophils with Charcot-Leyden crystals, histiocytes, eosinophilic granulomas
● Also dystrophic calcification
● Rarely eggs

Micro images
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65 year old woman

       
Various images

Videos
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Dr. Schall's Parasitology Reviews

End of Liver and intrahepatic bile ducts-nontumor > Infectious (non-viral) disorders > Fasciola hepatica (liver fluke)


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