Colorectal cancer in a patient with intestinal schistosomiasis: a case report from Kilimanjaro Christian Medical Center Northern Zone Tanzania.

BACKGROUND: Colorectal cancer associated with chronic intestinal schistosomiasis has been linked with the chronic inflammation as a result of schistosomal ova deposition in the submucosal layer of the intestine. Among all species Schistosoma japonicum has been more linked to development of colorectal cancer as compared to Schistosoma mansoni due to absence of population-based studies to support the association. Despite the weak evidence, some cases have been reported associating S. mansoni with development of colorectal cancer. CASE PRESENTATION: We report a patient who presented to us as a case of intestinal obstruction and found to have a constrictive lesion at the sigmoid colon at laparotomy, then later found to have colorectal cancer with deposited S. mansoni ova at histology. CONCLUSION: Given the known late complications of schistosomiasis, and as S. mansoni is endemic in some parts of Tanzania, epidemiological studies are recommended to shed more light on its association with colorectal cancer.

Evaluation of WGA and Concanavalin A (Con A) lectin as biomarkers of hepatosplenic schistosomiasis in human biopsies with no evidence of egg-granuloma system.

INTRODUCTION: Colonic lesions are predominant in patients with schistosomiasis. However, carbohydrate alterations in colonic schistosomiasis remain unclear. Lectin-ligands allow us to identify changes in the saccharide patterns of cells. METHODS: Biopsies of descending and rectosigmoid colon of patients were submitted to WGA and Con A lectin histochemistry. RESULTS: WGA stained stroma and gland cells of descending colon and rectosigmoid tissues in a granular strong cytoplasmatic pattern in schistosomiasis specimens differing from normal control and Con A failing to recognize all samples analyzed. CONCLUSIONS: WGA ligands are expressed differently in patients with hepatosplenic schistosomiasis and no evidence of egg-granuloma system.

Anisakidosis of the sigmoid colon disguising as metastatic carcinoma: a case report and review of the literature.

Intestinal anisakidosis is a rare nematode infestation caused by the ingestion of larvae-infected raw or undercooked fish. Most cases are incidentally diagnosed during surgery for other reasons. We present such a case of anisakid larvae seen in a patient's sigmoid colon resected for adenocarcinoma, where a subserosal nodule caused by the inflammatory reaction to the worm was presumed to be a lymph node involved by metastatic tumor. With the increasing popularity of raw fish consumption, the incidence of this parasitic infection is bound to increase, requiring surgical pathologists to be cognizant of its existence and aware of its histologic appearance.

Intestinal schistosomiasis caused by both Schistosoma intercalatum and Schistosoma mansoni.

A case is presented of intestinal schistosomiasis due to both Schistosoma intercalatum and Schistosoma mansoni in a 30-year-old man from Senegal with discussion of diagnostic approach, species identification and determination of the effect of treatment. The patient was admitted to hospital for investigation of renal failure, arterial hypertension and hypereosinophilia. Repeated stool examinations for ova and parasites were negative. Ultrasonography (US) and computed tomography (CT) of the abdomen showed no abnormalities. US of the urinary tract showed kidneys of borderline size with increased echogenicity. Cystoscopy and histopathological examination of bladder biopsy specimens were normal. Flexible colonoscopy revealed numerous nodular lesions in the rectosigmoid region and a few similar lesions in the transverse colon, the histopathological examination of which showed deposition of Schistosoma ova with granuloma formation. Examination of multiple crush biopsy specimens from the rectosigmoid region revealed numerous granulomas formed around Schistosoma eggs which had a terminal spine and were identified as S. intercalatum (longer than Schistosoma haematobium and with a slightly curved terminal spine) and a very few S. mansoni eggs. Crush biopsies from the lesions in the transverse colon showed only S. mansoni eggs. In conclusion, the examination of multiple crush biopsy specimens is a very sensitive and specific technique for species identification of Schistosoma, especially in mixed infections, and for defining the location and extent of the granulomas evoked by each species.

Bowel endometriosis and schistosomiasis: a rare but possible association.

OBJECTIVE: To report the case of a patient submitted to laparoscopic bowel resection in whom histology revealed endometriosis and schistosomiasis. DESIGN: Case report. SETTING: Multidisciplinary group practice and teaching hospital. PATIENT(S): A 31-year-old patient with pelvic pain. INTERVENTION(S): Laparoscopic bowel resection. MAIN OUTCOME MEASURE(S): Laparoscopic treatment of endometriosis affecting the sigmoid. RESULT(S): Histology performed on tissue removed at surgery revealed epithelioid granulomas with birefringent and partially calcified eggs characteristic of Schistosoma mansoni within an endometriotic lesion affecting the entire width of the sigmoid. CONCLUSION(S): Endometriosis and schistosomiasis may be present simultaneously in patients with bowel symptoms and pelvic pain.

Unusual endoscopic and microscopic view of Enterobius vermicularis: a case report with a review of the literature.

Enterobius vermicularis has the broadest geographic range of any helminth and is the most common intestinal parasite seen in the primary care setting. Underappreciated is the fact that it is not always a benign disorder and could even cause life-threatening medical problems. Visualization of the actual worms during endoscopy is probably underappreciated in part because endoscopists have never actually seen the worm and/or are not actively looking for, or anticipating, worms. This report describes a case of worm infection as documented during colonoscopy and confirmed by microscopy. The gross and microscopic appearance of the worm is described. Literature regarding the wide range of gastrointestinal and nongastrointestinal manifestations, including potentially life-threatening illnesses, as well as treatment options, are also reviewed.

[A man from Surinam with haemorrhagic diarrhoea after long-standing schistosomiasis]. / Een Surinaamse man met bloederige diarree na jarenlange onbekende schistosomiasis.

A 35-year-old man presented with a brief history of haemorrhagic diarrhoea. He had moved to The Netherlands 24 years before and had been in Surinam 12 years ago for the last time. Physical examination and routine laboratory tests revealed no abnormalities. Colonoscopy showed a striking congestion of the small blood vessels; histological examination of a sigmoid biopsy revealed Schistosoma eggs and microbiological investigation of the feces revealed ova of Schistosoma mansoni. The schistosomiasis was thus diagnosed more than 10 years after the last possible exposure to schistosomal cercariae. The patient was treated with a single dose of praziquantel.

A case of human fascioliasis in Qualyobia Governorate.

Human fascioliasis has been recently become a health problem in Alexandria and Dakahlia governorates. This paper report a new focus of human fascioliasis.

[Diagnosis of intestinal amebiasis]. / Diagnostik der intestinalen Amöbiasis.

Three cases of intestinal amebiasis with varying clinical pictures are presented. One patient developed an amebic liver abscess and also amebic colitis, which was mistaken for Crohn's disease. A second patient with amebic dysentery had no Entamoeba histolytica trophozoites in fecal material because of previous therapy with an antiprotozoal drug. The third patient, who had colitis and severe constitutional symptoms, had trophozoites in the stool but negative serological tests. The diagnostic value of radiology and endoscopy, of examinations of stool and exsudate, and of histopathology and serology is discussed.

[Intestinal amebiasis in children. I. Etiological study of colonic lesions of the rectosigmoid colon]. / La amebiasis intestinal en el niño. I. Estudio etiológico de las lesiones de colon rectosigmoideo.

A total of 253 children from two months to 12 years old, who had diarrheic or dysenteric syndromes, were studied from the rectosigmoidoscopic and parasitologic points of view. In addition, 112 and 20 of these patients were also studied bacteriologically and virologically, respectively. Only in 28 patients torphozoites of Entamoeba histolytica were found by means of direct microscopic examination, staining techniques and amoebal cultures. Enteropathogenic bacteria were isolated in 41 of the 112 cases examined. No viral particles were detected in the 20 cases studied. From the discussion of these results, the conclusion is reached that the rectosigmoidal mucusal alterations which have been currently considered as suggesting amoebal lessions are not characteristic of invasive intestinal amebiasis in children.