Buy Bogliolo. Patologia (Em Portuguese do Brasil) by Geraldo Brasileiro Filho ( ISBN: ) from Amazon’s Book Store. Everyday low prices and free . Buy Bogliolo. Patologia Geral (Em Portuguese do Brasil) by Geraldo Brasileiro Filho (ISBN: ) from Amazon’s Book Store. Everyday low prices. In: Brasileiro Filho, G. (ed.) Bogliolo Patologia. Editora GuanabaraKoogan, Rio de Janeiro, Brazil, pp. – Luz, Z.M.P., Coutinho, M.G., Cançado, J.R.
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The histopathological examination has shown a lesion, lined by a keratinized squamous epithelium, ulcerated, with granulomas, centered or not by Schistosoma mansoni egg, laid, in locoby the female present in the vascular lumen of a vein of the hemorrhoidal plexus.
There was also a diffuse, nonspecific inflammation in the dermis. The patient was treated with praziquantel. Four months after the treatment, sigmoidoscopy showed a normal rectal mucosa, and negative oogram and stool tests.
Ultrasound of abdomen was normal. Schistosomal polyps, although relatively rare, are more common among hyperplastic forms of schistosomiasis.
Their preferential site is the rectum, being rare in the sigmoid and exceptional in the other parts of the large and small intestines. In most cases, they are multiple, reaching even hundreds of polyps.
Their volume varies from the size of a rice grain to the size of a child’s fist. They consist of a conjunctive-vascular axis where eggs and granulomas are found, whether just a few or plenty of them, lined by the epithelium. The conjunctive-vascular neoformations which form the polyp excrescence are sometimes excessive regarding the number of eggs and the inflammatory reaction.
In general, this is unspecific and almost always eosinophilic followed by other exudate cells. Worms were found sometimes alive, either isolated or mating and sometimes dead, with the characteristic tissue reaction 1. Complications were limited to small hemorrhages.
However, there have been reports of rare cases of intestinal obstruction, with an invagination from the proximal to the distal portion, by a giant polyp located in the jejuno-ileal transition 2a large polyp mimicking a sigmoid 3 or rectal 4 tumor, with obstructive or hemorrhagic symptoms and a giant polyp with intussusception and exteriorization through the anus 5.
A case of condyloma acuminatum positive for human papiloma virus HPV with Schistosoma mansoni eggs in the lesion have been reported at the anal region of human imunudeficiency virus HIV -positive patient 6 as well as an association of anal fissure and a giant polyp with multiple calcified ova of Shistossoma mansoniin Cameroonian woman, HIV-positive, living in Germany 7. Moreover, a case of Shistossomal colonic polyposis has been described in a Ugandan man with advanced HIV-1 disease 8. The same association has also been observed in the uterine cervix.
The objective of our study was to report a case of anal polyp which was not associated with condyloma acuminatum in a patient with no history of HIV infection, caused by Schistosoma mansoni eggs.
Journal of Tropical Medicine
As far as we know, this is the first case in the Brazilian literature on a schistosomal polyp in the anus with these characteristics. Some months earlier, he noticed a tumor formation with a slow and progressive growth in the anal region, followed by pain and intense pruritus, with no bleeding and no secretion.
He has not complained of diarrhea or constipation.
He still reports pruritus and pain after defecation, which are alleviated with the use of an ointment as reported by the patient. His general health is good, and he is hydrated, afebrile, anicteric, acyanotic, not pale with no e, significant date. The macroscopy has shown a polypoid lesion was lined by a white irregular skin, with an area of superficial ulceration, measuring 2.
Section surface was whitish and firm. It was then divided in half and included in paraffin. The histopathological study has shown a lesion lined by a squamous epithelium, with an area of ulceration. When the epithelium was intact, irregular basal zone hyperplasia, acanthosis and papillomatosis and edema of Malphigian layer were observed.
In superficial areas of the epithelium, there are empty cavities or those filled with bogliool amorphous, paotlogia substance, with several sizes bogkiolo interspersed by cells with an increased volume, an acidophilic cytoplasm, nucleated or not Figure 1A.
Ulceration zone was represented by fibrinoid necrosis, consisting of fibrin, red blood cells, leukocytes and nucleus residues, on a layer of granulation tissue characterized by ectasic and congested vessels interspersed by fibrous connective and muscle bundles Figure 1B.
There is an intense chronic granulomatous inflammation in the dermis caused by schistosomiasis, characterized by the presence of several granulomas isolated or confluent, in several evolutionary stages, most of them in the exudative-productive stage, centered by Langhans or a foreign body type bogliplo cells, comprising the egg or its residues.
Tissue in fibrinoid necrosis, ectatic and congested vessels, marked nonspecific inflammatory infiltrate, with a predominance of eosinophils granulocytes and mononuclear cells, involving Schistosoma mansoni eggs arrows.
The most recent granulomas had a central necrosis around the egg involved by a layer of epithelioid macrophages and, more externally, by a mixture of cells with the predominance of mononuclear cells and patologix Figure 2A. Most of them did not have a concentric fibrosis, in onion drusens, which are characteristic of granulomas healing by fibrosis.
The presence of a couple of adult worms was observed in the lumen of a dermal vein Figure 2B. Both, mainly the female, had a schistosomal pigment hemozoinstaining part of the body in black. The female has still had a great number of oocytes. Their presence allows us to assume bogliiolo their posture occurred in loco and that the large number of eggs is due to successive postures.
B Couple of light worms in the vascular lumen. The female the smaller is hugged by the male, pagologia in black by the hemozoin pigment and with several oocytes. Marked infiltration of eosinophils and mononuclear cells around the egg. In bogliilo to the granulomatous inflammation, caused by the eggs, there was also another one, which was nonspecific and diffuse, consisting predominantly of mononuclear cells with a moderate amount of eosinophils, particularly intense in the superficial dermis and in the eroded area, involving vessels, nerves and muscular tissue and eggshells.
A light hemorrhage was detected by well-preserved red blood cells in the interstitium.
In obgliolo, chronic granulomatous inflammation caused by S. With the result of schistosomiasis, he was treated with six tablets of cestox, mg praziquantel.
He was then re-examined four months after the treatment, and was shown to have a good general health. Rectal mucosa was normal at retossigmoidoscopy; his oogram by rectal biopsy and parasitological stool exams were negative; his total abdominal ultrasound did not have any abnormalities; and intestinal, abdominal and neurological symptoms were absent.
The presence of anal patologiw was observed and it will be operated timely. As far as we know, this is the first case of polyp resulting from a chronic granulomatous inflammation caused by S.
The present case is different from the anal polyp described by Carneiro et al. Cutaneous involvement by Schistosoma haematobium occurred especially in the genital and perigenital regions where they start as assymptomatic papules which slowly become vegetative lesions 9 Cutaneous schistosomiasis caused by S. It may be associated with intestinal, hepatointestinal and hepatosplenic schistosomiasis or with neuroschistosomiasis.
In our case, it is associated to the intestinal form.
Schistosoma mansoni granuloma in late evolutive phase, in a case of tumoral form in man
There were no signs and symptoms for the diagnosis of the hepatosplenic form or of patollogia. Granulomatous reaction observed in this case is similar to that described in a pseudotumoral form of schistosomiasis mansoni Granulomas in several stages of evolution indicate oviposition in successive stages and that there was a modulation of the granulomatous reaction described in laboratory animals 14 and in human beings Changes in the surface of the epithelium were interpreted as traumatic, and caused by the use of toilet paper after defecation.
Raso P, Bogliolo L. Rev Bras Coloproct ; 5: Giant schistosomal granuloma mimicking rectum neoplasia: J Coloproctol ; Rev Bras Coloproct ; Condiloma bgoliolo anal com ovos de Schistosoma mansoni em paciente HIV-positivo.
Shistosomiasis in an HIV-positive patient presenting as an anal fissure ang giant anal polyp. Arch Dematol bbogliolo Shistossomal colonic polyposis ia an HIV-positive man. Cutaneous manifestations of schistosomiasis. Intern J Dermat ; 3: Paotlogia bilharziasis cutanea tarda. J Cutaneous Path ; Ectopic cutaneous schistosomiasis report of two cases and a review of literature.
Anal polyp caused by Schistosoma mansoni
Schistosomiasis mansoni in the sacral region. Schistosoma mansoni granuloma in late evolutive phase, in a case of tumoral form in man. Rev Soc Bras Med Trop ; Mild prolonged schistosomiasis in mice: Mapeamento do risco de esquistossomose no Estado de Minas Gerais usando fm ambientais e sociais.
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Cases Reports Anal polyp caused by Schistosoma mansoni. Schistosoma mansoni ; Anal polyp; Anus; Schistosomiasis. Acknowledgements To Carolina Dias for the English version. How to cite this article.