Hepatic echinococcus granulosus: a clinicopathological analysis of thirteen cases
10.3760/cma.j.cn112151-20210202-00119
- VernacularTitle:肝脏细粒棘球蚴病13例临床病理学特征
- Author:
Lisha LIU
1
;
Weiping GUO
;
Yuefeng WANG
;
Yu DONG
;
Ying TUO
;
Sheng WANG
;
Shuang WAN
;
Tashi PHUNTSOK
;
Lin PENG
;
Jian LI
;
Anjia HAN
;
Dawei LIU
Author Information
1. 西藏林芝市人民医院病理科 860000
- Keywords:
Liver diseases;
Parasitic diseases;
Pathology;
Immunohistochemistry
- From:
Chinese Journal of Pathology
2021;50(6):650-654
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinicopathologic characteristics of hepatic echinococcus granulosus (HEG).Methods:Thirteen cases of HEG were collected from Linzhi People′s Hospital between January 2017 to October 2020, and their clinicopathologic features, ultrasound classi?cation, immunophenotype and histochemical data were analyzed, retrospectively and the relevant literature was reviewed.Results:Thirteen patients (5 male patients, 8 female patients) were included in this cohort, and the mean age was 40 years. The most common clinical presentation was mild abdominal distention and pain (9/13). Based on WHO-IWGE ultrasound standardized classi?cation, these cases were classified into 5 types, including type CL (1 case), type CE1 (2 cases), type CE2 (4 cases), type CE3 (3 cases) and type CE4 (3 cases). Gross examination revealed a solitary cyst localized in the liver, varying from 2.7 to 13.5 cm in diameter, and most of them(10/13)were more than 10 cm. Histopathologically, these cysts possessed a thin inner germinal layer and outer adventitial layer, and a central cavity ?lled with a clear"hydatid"?uid. The germinal layer was continuous and generated brood capsules and protoscoleces. The laminated membranes were clearly demonstrated by elastic fiber and Gomori′s stains. Inside the"mother"cyst, there were a varying number of"daughter"vesicles of variable sizes. The inflammatory reaction around the cyst consisted of eosinophils, mononuclear cells immediately next to the cyst layer and sometimes formed granuloma and giant cells resembling the Langhan′s type giant cells. The lymphoid cells were positive for CD20 and CD3. The CD68 immunohistochemistry clearly demonstrated epithelioid cells of granuloma in two cases. Moreover, immunohistochemistry revealed plasma cells were locally positive for CD38, IgG and IgG4, but not meeting the criteria for IgG4 related lesion.Conclusions:Hepatic echinococcus granulosus is a zoonotic parasitic disease prevalent in pastoral areas such as Tibet. It is important to understand its clinical features, ultrasound characteristics and histological morphology.
