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Pan W, Guo J, Li J, Su J, Zhang X, Liu J, Xu C, Hou Y. Presence of schistosome eggs in lymph node predict unfavorable prognosis in schistosomal colorectal cancer. Eur J Cancer Prev 2023; 32:566-574. [PMID: 37200090 PMCID: PMC10538618 DOI: 10.1097/cej.0000000000000811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 04/10/2023] [Indexed: 05/20/2023]
Abstract
OBJECTIVE The purpose of this study was to investigate the prognostic significance of schistosome eggs' location in schistosomal colorectal cancer (SCRC). METHODS 172 cases of SCRC were retrospectively analyzed. Patient clinicopathological parameters and survival rates were analyzed. RESULTS There were 102 males and 70 females, the median age was 71 years (range, 44-91). All patients were followed, and the median time was 50.1 months (range, 1.0-79.7). There were 87 patients with PS1 (presence site 1, eggs deposited in the mucosa) and 85 patients with PS2 (presence site 2, eggs deposited in the muscularis propria or throughout the full thickness of the intestinal wall), 159 patients presented with eggs in cutting edge and 83 patients presented with eggs in lymph node (LN). Hepatic schistosomiasis was found in 27.3% of patients by imaging modalities and correlated to patients with PS2 ( P < 0.001) and LNs' eggs ( P < 0.001). Survival analyses showed that in stage III SCRC, eggs' presence in LN associated with worse DFS ( P = 0.004) or marginally worse OS ( P = 0.056), patients with PS2 had shorter OS ( P = 0.044). Multivariate analyses revealed hepatic schistosomiasis was an independent prognostic factor for DFS and OS in stage III SCRC ( P = 0.001, 0.002, respectively). In adjusted multivariate analysis, eggs' presence in LN was an independent prognostic factor for DFS in stage III SCRC ( P = 0.006). CONCLUSIONS In stage III SCRC, eggs' presence in LN could predict poor prognosis and hepatic schistosomiasis was an independently unfavorable prognosis factor.
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Affiliation(s)
- Weiyu Pan
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Jiaojiao Guo
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Jiali Li
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Jieakesu Su
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Xiaolei Zhang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Jia Liu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Chen Xu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
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Koulali H, Zazour A, Khannoussi W, Kharrasse G, Ismaili Z. Colonic schistosomiasis: A case report. World J Gastrointest Endosc 2022; 14:789-794. [PMID: 36567820 PMCID: PMC9782564 DOI: 10.4253/wjge.v14.i12.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/20/2022] [Accepted: 11/19/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Schistosomiasis is a chronic parasitic infection endemic in many countries. Colonic schistosomiasis is a rare entity with no specific clinical manifestations or endoscopic aspects, which delays the diagnosis. Diagnosis is primarily dependent on histopathological analysis, and treatment with antihelminthics typically resolves the infection.
CASE SUMMARY We present the case of a 21-year-old male who suffered from chronic diarrhea and abdominal pain. Physical examination found no abnormalities, blood tests were normal, and stool examination was negative. A colonoscopy revealed a nodular terminal ileal mucosa, two cecal polypoid lesions with no particular surface pattern, and millimetric erosions in the rectum. The presence of Schistosoma eggs with thick peripheral capsules and viable embryos inside and numerous eosinophils surrounding the egg capsule were observed on histopathological examination. The patient received praziquantel, and his symptoms were resolved.
CONCLUSION Colonic schistosomiasis should be considered as a differential diagnosis, especially in endemic countries. Endoscopy and histopathological examination can confirm the diagnosis, and antihelminthics are an effective treatment.
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Affiliation(s)
- Hajar Koulali
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
| | - Abdelkrim Zazour
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
| | - Wafaa Khannoussi
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
| | - Ghizlane Kharrasse
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
| | - Zahi Ismaili
- Department of Gastro-enterology, Mohammed VI University Hospital, Oujda 60050, Morocco
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Unique Case of a Hamartomatous Duodenal Polyp Associated With Intestinal Schistosomiasis. ACG Case Rep J 2021; 8:e00485. [PMID: 33532510 PMCID: PMC7846420 DOI: 10.14309/crj.0000000000000485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/17/2020] [Indexed: 11/17/2022] Open
Abstract
Schistosomiasis is a trematode infection rarely diagnosed in the United States. Intestinal involvement is common with chronic infection and causes abdominal pain, changes in bowel habits, hematochezia, and polyp formation. Chronic, disseminated infection can affect the intestines causing the aforementioned symptoms, but reports of intestinal polyps are rare. Most cases are inflammatory fibrous polyps in the colon. There are very few cases reported in the literature of hamartomatous polyps arising in the small intestine. We present the rare case of a U.S.-born, 35-year-old woman diagnosed with a large duodenal hamartomatous polyp in the setting of intestinal schistosomiasis.
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Al-Zubaidi AM, Bashanfer GA, Alqannas MH, Al Atawi AS. Colonic Polyps an Unusual Manifestation of Schistosomiasis. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e923177. [PMID: 32764533 PMCID: PMC7476750 DOI: 10.12659/ajcr.923177] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Patient: Male, 24-year-old Final Diagnosis: Large rectal polyps secondary to Schistosoma infection • Unusual colonic polyp caused by Schistoma infection Symptoms: Abdominal pain • bleeding per rectum Medication: During the procedure: Xylocaine local gel • Midazolam inj • Fentanyl inj; For the disease: Praziquantel tab Clinical Procedure: Colonoscopy with endoscopic submucosal resection (EMR) • endoscopic submucosal resection (EMR) Specialty: Gastroenterology and Hepatology • Endoscopy
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Affiliation(s)
- Ali Mothanna Al-Zubaidi
- Department of Medicine, Endoscopy Unit, King Khalid Hospital, Najran, Saudi Arabia.,Department of Medicine, College of Medicine, Najran University, Najran, Saudi Arabia
| | - Galal Ahmed Bashanfer
- Deparment of Laboratory, Histopathology Section, King Khalid Hospital, Najran, Saudi Arabia
| | - Mashhour H Alqannas
- Department of Surgery, Bariatric Surgery, King Khalid Hospital, Najran, Saudi Arabia
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Wang W, Lu K, Wang L, Jing H, Pan W, Huang S, Xu Y, Bu D, Cheng M, Liu J, Liu J, Shen W, Zhang Y, Yao J, Zhu T. Comparison of non-schistosomal colorectal cancer and schistosomal colorectal cancer. World J Surg Oncol 2020; 18:149. [PMID: 32611359 PMCID: PMC7330999 DOI: 10.1186/s12957-020-01925-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/18/2020] [Indexed: 01/13/2023] Open
Abstract
Aim The purpose of this study was to compare clinicopathological features of patients with non-schistosomal and schistosomal colorectal cancer to explore the effect of schistosomiasis on colorectal cancer (CRC) patients’ clinical outcomes. Methods Three hundred fifty-one cases of CRC were retrospectively analyzed in this study. Survival curves were constructed by using the Kaplan-Meier (K-M) method. Univariate and multivariate Cox proportional hazard regression models were performed to identify associations with outcome variables. Results Colorectal cancer patients with schistosomiasis (CRC-S) were significantly older (P < 0.001) than the patients without schistosomiasis (CRC-NS). However, there were no significant differences between CRC-S and CRC-NS patients in other clinicopathological features. Schistosomiasis was associated with adverse overall survival (OS) upon K-M analysis (P = 0.0277). By univariate and multivariate analysis, gender (P = 0.003), TNM stage (P < 0.001), schistosomiasis (P = 0.025), lymphovascular invasion (P = 0.030), and lymph nodes positive for CRC (P < 0.001) were all independent predictors in the whole cohort. When patients were stratified according to clinical stage and lymph node metastasis state, schistosomiasis was also an independent predictor in patients with stage III–IV tumors and in patients with lymph node metastasis, but not in patients with stage I–II tumors and in patients without lymph node metastasis. Conclusion Schistosomiasis was significantly correlated with OS, and it was an independent prognostic factor for OS in the whole cohort. When patients were stratified according to clinical stage and lymph node metastasis state, schistosomiasis was still an independently unfavorable prognosis factor for OS in patients with stage III–IV tumors or patients with lymph node metastasis.
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Affiliation(s)
- Weixia Wang
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Kui Lu
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Limei Wang
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Hongyan Jing
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Weiyu Pan
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Sinian Huang
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Yanchao Xu
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Dacheng Bu
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Meihong Cheng
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Jing Liu
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Jican Liu
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Weidong Shen
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Yingyi Zhang
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Junxia Yao
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China
| | - Ting Zhu
- Department of Pathology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital, No.1158 Gongyuan East Road, Qingpu District, Shanghai, 201700, People's Republic of China.
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The Reply. Am J Med 2018; 131:e165. [PMID: 29555044 DOI: 10.1016/j.amjmed.2017.11.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/27/2017] [Indexed: 11/23/2022]
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Kiyani A, Walia A, Chuang KY. Schistosoma japonicum Presenting as Colon Polyps. Am J Med 2018; 131:e149-e150. [PMID: 29032231 DOI: 10.1016/j.amjmed.2017.09.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 09/27/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Amirali Kiyani
- Department of Hepatology and Liver Transplant, Baylor College of Medicine, Houston, Texas.
| | | | - Keng-Yu Chuang
- Department of Gastroenterology, Maricopa Medical Center, Phoenix, Ariz
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Lima CWR, Oliveira NMCD, Silva SVDD, Duarte MEL, Barbosa APF. Ectopic forms of schistosomiasis mansoni in the second macroregion of Alagoas: case series report and review of the literature. Rev Soc Bras Med Trop 2018; 50:812-818. [PMID: 29340459 DOI: 10.1590/0037-8682-0087-2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 11/30/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Ectopic forms of schistosomiasis are those in which the parasitic element is localized outside the portal system, the natural habitat of the helminth. Although the prevalence rates of schistosomiasis are high in Brazil, clinical and epidemiological data on ectopic forms of the disease are still scarce. METHODS Cross-sectional, retrospective and descriptive epidemiological study in which cases with a confirmed histopathological diagnosis of an ectopic form of schistosomiasis were analyzed. The cases were selected from a database of the anatomic pathology files of a referral center. RESULTS Of the 21 cases identified, seven affected the female genital tract and five the male genital tract; four cases were identified in the peritoneum; two cases involved lymph nodes and two involved adipose tissue; and renal involvement was detected in one case. CONCLUSIONS The lack of knowledge of the clinical presentation of ectopic forms of schistosomiasis makes the early identification and treatment of this form difficult, with direct implications in the reduction of morbidity and mortality in endemic areas.
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Feng H, Lu AG, Zhao XW, Han DP, Zhao JK, Shi L, Schiergens TS, Lee SML, Zhang WP, Thasler WE. Comparison of non-schistosomal rectosigmoid cancer and schistosomal rectosigmoid cancer. World J Gastroenterol 2015; 21:7225-32. [PMID: 26109809 PMCID: PMC4476884 DOI: 10.3748/wjg.v21.i23.7225] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 03/13/2015] [Accepted: 04/28/2015] [Indexed: 02/06/2023] Open
Abstract
AIM To compare the clinicopathological features of patients with non-schistosomal rectosigmoid cancer and schistosomal rectosigmoid cancer. METHODS All the patients with rectosigmoid carcinoma who underwent laparoscopic radical surgical resection in the Shanghai Minimally Invasive Surgical Center at Ruijin Hospital affiliated to Shanghai Jiao-Tong University between October 2009 and October 2013 were included in this study. Twenty-six cases of colonic schistosomiasis diagnosed through colonoscopy and pathological examinations were collected. Symptoms, endoscopic findings and clinicopathological characteristics were evaluated retrospectively. RESULTS There were no significant differences between patients with and without schistosomiasis in gender, age, CEA, CA19-9, preoperative biopsy findings or postoperative pathology. Patients with rectosigmoid schistosomiasis had a significantly higher CA-125 level and a larger proportion of these patients were at an early tumor stage (P = 0.003). Various morphological characteristics of schistosomiasis combined with rectosigmoid cancer could be found by colonoscopic examination: 46% were fungating mass polyps, 23% were congestive and ulcerative polyps, 23% were cauliflower-like masses, 8% were annular masses. Only 27% of the patients were diagnosed with rectal carcinoma preoperatively after the biopsy. Computed tomography (CT) scans showed thickened intestinal walls combined with linear and tram-track calcifications in 26 patients. CONCLUSION Rectosigmoid carcinoma combined with schistosomiasis is associated with higher CA-125 values and early tumor stages. CA-125 and CT scans have a reasonable sensitivity for the accurate diagnosis.
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From Bench to Bedside: Natural Products and Analogs for the Treatment of Neglected Tropical Diseases (NTDs). STUDIES IN NATURAL PRODUCTS CHEMISTRY 2015. [DOI: 10.1016/b978-0-444-63460-3.00002-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Issa I, Osman M, Aftimos G. Schistosomiasis manifesting as a colon polyp: a case report. J Med Case Rep 2014; 8:331. [PMID: 25296942 PMCID: PMC4196203 DOI: 10.1186/1752-1947-8-331] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2014] [Accepted: 08/19/2014] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Schistosomiasis is a rare disease with a common intestinal involvement. However, colon polyps associated with Schistosoma in the absence of inflammation have rarely been reported, especially in young people; this is the first case with the following presentation. CASE PRESENTATION We describe the case of a 20-year-old Ethiopian woman living in Lebanon who presented with nonspecific abdominal symptoms. Her biochemical profile was normal in addition to the results of her stool and urine tests. A colonoscopy showed normal colonic mucosa but surprisingly a large pedunculated polyp was found in her ascending colon. Pathology revealed a hamartomatous polyp but it was full of partially calcified parasitic eggs of Schistosoma mansoni compatible with chronic schistosomiasis. CONCLUSIONS She was treated with two doses of praziquantel and showed immediate marked clinical improvement. This unusual case will give us the opportunity to discuss schistosomiasis, its occurrence in colon polyps, clinical significance and the various means of management.
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Affiliation(s)
- Iyad Issa
- Department of Gastroenterology and Hepatology, Rafic Hariri University Hospital (RHUH), Beirut, Lebanon.
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Ali MA, Arnold CA, Singhi AD, Voltaggio L. Clues to uncommon and easily overlooked infectious diagnoses affecting the GI tract and distinction from their clinicopathologic mimics. Gastrointest Endosc 2014; 80:689-706. [PMID: 25070906 DOI: 10.1016/j.gie.2014.04.065] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Accepted: 04/29/2014] [Indexed: 02/07/2023]
Affiliation(s)
- M Aamir Ali
- Department of Gastroenterology, George Washington University Hospital, Washington, District of Columbia, USA
| | | | - Aatur D Singhi
- Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lysandra Voltaggio
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland, USA
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Ye C, Tan S, Jiang L, Li M, Sun P, Shen L, Luo H. Endoscopic characteristics and causes of misdiagnosis of intestinal schistosomiasis. Mol Med Rep 2013; 8:1089-93. [PMID: 23969514 DOI: 10.3892/mmr.2013.1648] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 07/27/2013] [Indexed: 01/30/2023] Open
Abstract
The aim of this study was to determine the clinical and endoscopic manifestations, and pathological characteristics of intestinal schistosomiasis in China, in order to raise awareness of intestinal schistosomiasis and prevent misdiagnosis and missed diagnosis. The retrospective analysis of clinical and endoscopic manifestations, and histopathological characteristics, were conducted for 96 patients with intestinal schistosomiasis. Among these patients, 21 lived in areas that were not infected with Schistosoma and 25 (26%) had no history of schistosome infection or contact with infected water. These patients were mainly hospitalized due to symptoms of diarrhea, mucus and bloody purulent stool. Sixteen cases were of the acute enteritis type, and colonoscopy results determined hyperaemic edema and dispersed small mucosal ulcers. The acute infection in patients was pathologically characterized by the deposition of intact ova with a large quantity of eosinocyte infiltration. Forty‑one cases were of the chronic enteritis type which predominantly manifested with yellow nodules and disorder of the vascular surfaces in the intestines. Thirty‑nine cases were diagnosed with mixed type enteritis, which demonstrated acute and chronic histopathological appearances. In addition, six cases of complicated colorectal cancer were observed. Of the 24 misdiagnosed patients, eight were misdiagnosed with ulcerative colitis, five with colorectal cancer, five with colorectal tuberculosis, four with chronic bacillary dysentery and two with irritable bowel syndrome. Intestinal schistosomiasis demonstrated no specific clinical or endoscopic manifestations and it was determined that patients with abdominal pain, diarrhea and mucous stool may be infected with intestinal schistosomiasis. Epidemiological investigations and colonoscopy combined with multi‑block and multi‑site biopsies may improve the diagnosis of intestinal schistosomiasis. In addition, it is necessary for intestinal schistosomiasis to be followed up by colonoscopy, due to its possible correlation with colorectal tumors.
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Affiliation(s)
- Chuncui Ye
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
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Chopra S, Wu MLC. Specimens from biopsies of colorectal polyps often harbor additional diagnoses. PATHOLOGY RESEARCH INTERNATIONAL 2013; 2013:570526. [PMID: 24455417 PMCID: PMC3886612 DOI: 10.1155/2013/570526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 11/13/2013] [Indexed: 12/11/2022]
Abstract
Objectives. The utility of examining specimens from colorectal biopsies of polyps for nonneoplastic diseases is currently unknown. Our objectives were to characterize such additional diagnoses that could be rendered. Methods. We retrospectively and prospectively reviewed specimens from endoscopic biopsies of colorectal polyps obtained during routine screening or surveillance. Results. 17 of 168 specimens (10.1%) contained additional diagnoses, including schistosomiasis, eosinophilic colitis, intestinal spirochetosis, melanosis coli, and other entities. These findings were easily overlooked because they often affected mucosa that was spared by the polyps or were often evident only at high magnification. Schistosomiasis, eosinophilic colitis, and intestinal spirochetosis were clinically occult. Conclusions. Specimens from biopsies of colorectal polyps often harbor other diagnoses, in addition to polyps, and can be simultaneously screened for polyps and examined for nonneoplastic diseases. Detection of other diagnoses in addition to polyps requires awareness, examination at high magnification, and examination of areas spared by the polyps.
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Affiliation(s)
- Shefali Chopra
- Department of Pathology and Laboratory Medicine, University of California Irvine School of Medicine, Irvine, CA 92868, USA
| | - Mark Li-cheng Wu
- Department of Pathology and Laboratory Medicine, University of California Irvine School of Medicine, Irvine, CA 92868, USA
- *Mark Li-cheng Wu:
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Gastrointestinal neoplasia associated with bowel parasitosis: real or imaginary? J Trop Med 2011; 2011:234254. [PMID: 22174720 PMCID: PMC3235815 DOI: 10.1155/2011/234254] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 10/19/2011] [Accepted: 10/20/2011] [Indexed: 02/01/2023] Open
Abstract
Several parasitic species are well known to have carcinogenic properties, namely; Schistosoma hematobium (squamous cell carcinoma of the bladder) and the liver flukes Opisthorchis and Chlonorchis (cholangiocarcinoma). A large number of parasites are known to colonize the gastrointestinal tract. We sought to review the evidence that implicates these parasites in gastrointestinal neoplasia. Schistosoma japonicum, which is endemic primarily in east Asia, has been shown in multiple studies to convey a mildly increased risk of colorectal adenocarcinoma. The data supporting a causative role for Schistosoma mansoni in colorectal or other neoplastic processes are less convincing, limited primarily to small case-control studies and case series. Reports of possible associations between other gastrointestinal parasites (e.g., E. histolytica and A. lumbricoides) and neoplasia may be found in the literature but are limited to individual cases. We conclude that, other than S. japonicum and to a lesser extent S. mansoni, there is little evidence of an association between gastrointestinal parasites and neoplasia.
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Hamed MAA, Ahmed SAA, Khaled HM. Efficiency of diagnostic biomarkers among colonic schistosomiasis Egyptian patients. Mem Inst Oswaldo Cruz 2011; 106:322-9. [PMID: 21655820 DOI: 10.1590/s0074-02762011000300011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2010] [Accepted: 01/05/2011] [Indexed: 12/13/2022] Open
Abstract
The schistosomal parasite plays a critical role in the development of malignant lesions in different organs. The pathogenesis of cancer is currently under intense investigation to identify reliable prognostic indices for disease detection. The objective of this paper is to evaluate certain biochemical parameters as diagnostic tools to efficiently differentiate between colonic carcinoma and colonic carcinoma associated with schistosomal infection among Egyptian patients. The parameters under investigation are interleukin 2 (IL-2), tumour necrosis factor alpha (TNF-α), carcinoembryonic antigen (CEA) levels, tissue telomerase, pyruvate kinase (PK), glucose-6-phosphate dehydrogenase (G-6-PD) and lactate dehydrogenase (LDH) enzyme activities. The results revealed a significant elevation in the level of the tumour markers IL-2, TNF-α and CEA as well as the activities of LDH, telomerase and G-6-PD among non-bilharzial and bilharzial colonic cancer groups, with a more potent effect in bilharzial infection-associated colonic cancer. A significant inhibition in PK activity was recorded in the same manner as compared to normal tissues. The efficacy of this biomarker was also evaluated through detecting sensitivity, specificity, negative and positive predictive values. In conclusion, schistosomal colonic carcinoma patients displayed more drastic changes in all parameters under investigation. The combination of the selected parameters succeeded in serving as biomarkers to differentiate between the two malignant types.
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Canepa M, Fanta PT, Weidner N, Peterson MR. Schistosomiasis and signet ring cell carcinoma of the rectum. Ann Diagn Pathol 2011; 16:385-7. [PMID: 21546296 DOI: 10.1016/j.anndiagpath.2010.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 10/12/2010] [Accepted: 12/06/2010] [Indexed: 11/17/2022]
Abstract
A definitive link between Schistosoma hematobium infection and squamous cell carcinoma of the bladder has been identified. A weaker association between S japonicum infection and colorectal neoplasia has been proposed, although reports are limited to case reports, a case series, and epidemiologic studies. Virtually all cases presented in the literature describe intestinal-type adenocarcinoma occurring in association with S japonicum. We here describe a 40-year-old male Filipino patient with signet ring cell carcinoma of the rectum and evidence of infection by S japonicum.
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Affiliation(s)
- Mariana Canepa
- Department of Pathology, University of California, San Diego, 92103, USA
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18
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Schmitt F, Oliveira MH. Oesophagus and gastrointestinal tract. Diagn Cytopathol 2010. [DOI: 10.1016/b978-0-7020-3154-0.00007-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Horiuchi A, Nakayama Y, Sano K. Hepatic ultrasound appearance and colonoscopic finding of schistosomiasis japonica. Clin Gastroenterol Hepatol 2008; 6:A24. [PMID: 18585968 DOI: 10.1016/j.cgh.2008.02.066] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2008] [Accepted: 02/26/2008] [Indexed: 02/07/2023]
Affiliation(s)
- Akira Horiuchi
- Department of Gastroenterology, Showa Inan General Hospital, Komagane, Japan
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