Non-necrotizing colonic granuloma induced by schistosomiasis

Abstract

Schistosomiasis is an important parasitic disease with various clinical presentations caused by trematode blood flukes. It can present with asymptomatic, chronic colonic ulcerations, strictures, or inflammatory mass causing bowel obstruction. Intestinal polyps are uncommon and induced by antigens released from the schistosome eggs that trigger a cell-mediated inflammatory response with granuloma formation involving T cells, macrophages, and necrosis. This is very relevant while evaluating chronic intermittent gastrointestinal symptoms and eosinophilia in an immigrant patient from endemic areas of schistosomiasis. Here, we describe a case of chronic intestinal schistosomiasis which was found to have schistosomiasis-induced colonic polyp with non-necrotizing granuloma. With increase in immigrant population from the endemic areas of schistosomiasis in the United States, physicians should be aware of this disease and its various manifestations. Gastroenterologist should keep this as one of the differentials for colonic polyps. Diagnosis and treatment in time prevents further progression of the disease and its complications.

A Current Perspective of Schistosomiasis in Association with Colorectal Carcinogenesis

“…The overall examination of the specimen showed an ulcerated tumour, S. mansoni ova in a cancerous tumour and colonic submucosa, where eggs were seen more in tumour tissue than in normal tissue. This case is consistent with the conditions of the infection, whereby intestinal Schistosomiasis induces various pathologic conditions, including carcinoma [11,15,17,42,45,46], lymphoma [15,47] polyps [17,48,49], carcinoid [43] and pedunculated teratoma [43].…”