گزارش يك مورد فاسيوليازيس اكتوپيك پريتوان قابل افتراق از تومور بدخيم از بيمارستان فاطمي اردبيل

Title

ECTOPIC FASCIOLIASIS OR PERITONEAL MALIGNANCY TUMORS? (CASE REPORT)

English Abstract

Ectopic fascioliasis usually caused by juvenile Fasciola Spp., but in recent years a few cases of tissue-embedded ova have been reported from different areas. A 79 years old Iranian man resident in Ardabil province, complained with abdominal pain, nausea and intestinal obstruction symptoms referred to Fatemi hospital. The patient was operated with impression of intestinal obstruction. In laparotomy multiple intestinal masses with peritoneal seeding resembling of a malignant lesion were seen. Moreover local intestinal necrosis and multiple lymphadenopathy were noticed. After appendectomy and peritoneal mass biopsy with numerous intraperitoneal adenopathy, paraffin embedded blocks were prepared from each tissues. A blood sample was taken from the patient five month later for serological diagnosis.Histopathological examination of sections showed fibrofatty stroma with dense mixed inflammatory cell infiltration and fibrosis in peritoneal masses. The inflammatory cells were include lymphoplasma cells and abundant eosinophils. Large numbers of ova of Fasciola spp. were also noted with typical circumscribed granulomas (circumoval granulomas). A few circumscribed granulomas were also noted on the serosa of appendix and perinodal soft tissues.IHA test for detecting anti Fasciola hepatica antibodies was positive five months after surgery with a titer of 1/128. Due to multiple clinical manifestation of extra-hepatic fascioliasis, its differential diagnosis from intraperitoneal tumors should be considered.

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