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Schistosoma mansoni granuloma in late evolutive phase, in a case of tumoral form in man.
- Source :
-
Revista da Sociedade Brasileira de Medicina Tropical [Rev Soc Bras Med Trop] 2012 Oct; Vol. 45 (5), pp. 627-32. - Publication Year :
- 2012
-
Abstract
- Introduction: Authors describe human schistosomal granuloma in late chronic phase, from the morphological and evolutionary viewpoints.<br />Methods: The study was based on a histological analysis of two fragments obtained from a surgical biopsy of peritoneum and large intestine of a 42-year-old patient, with a pseudotumoral form mimicking a peritoneal carcinomatosis associated to the schistosomiasis hepatointestinal form.<br />Results: Two hundred and three granulomas were identified in the pseudotumor and 27 in the intestinal biopsy, with similar morphological features, most in the late chronic phase, in fibrotic healing. A new structural classification was suggested for granulomas: zone 1 (internal), 2 (intermediate) and 3 (external).<br />Conclusions: Regarding granuloma as a whole, we may conclude that fibrosis is likely to be controlled by different and independent mechanisms in the three zones of the granuloma. Lamellar fibrosis in zone 3 seems to be controlled by matrix mesenchymal cells (fibroblasts and myoepithelial cells) and by inflammatory exudate cells (lymphocytes, plasmocytes, neutrophils, eosinophils). Annular fibrosis in zone 2, comprising a dense fibrous connective tissue, with few cells in the advanced phase, would be controlled by epithelioid cells involving zone 1 in recent granulomas. In zone 1, replacing periovular necrosis, an initialy loose and tracery connective neoformation, housing stellate cells or with fusiform nuclei, a dense paucicellular nodular connective tissue emerges, probably induced by fibroblasts. In several granulomas, one of the zones is missing and granuloma is represented by two of them: Z3 and Z2, Z3 and Z1 or Z2 and Z1 and, ultimately, by a scar.
- Subjects :
- Adult
Animals
Fibrosis
Granuloma parasitology
Humans
Immunomodulation physiology
Intestinal Diseases, Parasitic parasitology
Liver parasitology
Liver pathology
Liver Diseases, Parasitic pathology
Male
Neglected Diseases parasitology
Schistosomiasis mansoni immunology
Granuloma pathology
Intestinal Diseases, Parasitic pathology
Neglected Diseases pathology
Peritoneal Diseases pathology
Schistosoma mansoni
Schistosomiasis mansoni pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1678-9849
- Volume :
- 45
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Revista da Sociedade Brasileira de Medicina Tropical
- Publication Type :
- Academic Journal
- Accession number :
- 23152348
- Full Text :
- https://doi.org/10.1590/s0037-86822012000500016