The histopathology of early hepatic schistosomiasis'"

Abstract

The late stages of hepatic schistosomiasis (pipestem portal fibrosis) were first described from hyperendemic areas of Schistosoma Menotti in Egypt and South America. More recently all grades of hepatic schistosomiasis have been reported from endemic areas of S. Menotti as well. There is, however, a discrepancy in the histopathologic^! descriptions of hepatic lesions. This paper presents the author's experience with hepatic schistosomiasis in an endemic area of 5. Menotti in Zambia. The unit of the schistosome lesion is the pseudo-tubercle which develops around the individual eggs. Confluence of these granulomata has a role in the subsequent development of the more severe chronic stages of portal fibrosis. The late stages of pipe-stem portal fibrosis of the liver due to schistosomiasis are well documented from the major endemic areas of Schistosoma mansotti in Egypt and South America. This clinicopathological entity of schistosomal pipe-stem portal fibrosis of the liver, after initial debate and scepticism (Higginson & de Meillon, 1955; Prates, 1961; Gclfand, 1962) is being more frequently reported from endemic areas of Africa as well (Manson-Bahr, 1958; Bhagwandeen, 1964, 1968, 1973; Gelfand, 1964). The entire spectrum of liver disease as described by ihc author in an endemic area of S. mansotti in South Africa (Durban) is also being seen in Zambia (Bhagwandeen, 1973). Zambia also is an endemic area of schistosomiasis with focal endemicity of both S. haematobium (Bhagwandeen, 1970) and S. mansotti (Henderson, 1969)