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Liver and intrahepatic bile ducts-nontumor

Infectious (non-viral) disorders

Schistosomiasis


Reviewers: Komal Arora, M.D. (see Reviewers page)
Revised: 10 May 2012, last major update May 2012
Copyright: (c) 2004-2012, PathologyOutlines.com, Inc.

General
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● Flat worms (trematodes) with species S. haematobium, S. intercalatum, S. japonicum, S. mansoni, S. mekongi
● All but S. haematobium parasitize intestinal venules and may spread to liver
● Infect millions in Asia, Africa and South America; rare in US

Infectious cycle:
● Fresh water snails release cercarial form into water
● Cercarie are mobile and penetrate human skin or mucosa, enter circulation, pass through lungs and lodge in hepatic branches of portal vein
● Mature into adults, copulate and migrate to colonic and rectal submucosa where female releases ova that enter colonic lumen, are defecated, and infect other snails
● Ova may also enter portal circulation and cause periportal fibrosis
● Rarely adult S. mansoni worms are identified in hepatic branches of portal vein (10-16 mm)

Gross description
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● Pipe stem fibrosis of cut surface
● No cirrhosis unless coexisting hepatitis B

Micro description
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● Portal eosinophilic infiltrate with granulomas containing ova with characteristic lateral spine; dense periportal fibrosis

Micro images
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Eggs in intestinal mucosa


Dense periportal fibrosis

Additional references
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Parasite Immunol 2009;31:656

End of Liver and intrahepatic bile ducts-nontumor > Infectious (non-viral) disorders > Schistosomiasis


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