Simple liver cysts and cystoid lesions in hepatic alveolar echinococcosis: a retrospective cohort study with Hounsfield analysis

Engler, Agata; Shi, Rong; Beer, Meinrad; Schmidberger, Julian; Kratzer, Wolfgang; Barth, Thomas F.E.; Grimm, Johannes; Hillenbrand, Andreas; Henne‐Bruns, Doris; Gruener, Beate; Beer, Ambros; Graeter, Tilmann

doi:10.1051/parasite/2019057

Cited by 15 publications

(26 citation statements)

References 39 publications

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“…The sequential lesion evolution will then be taken into account by a corresponding adapted sequence of the numbered lesion types. Recently published studies regarding epidemiological CT data from Europe and China, as well as the analyses of different CT morphological types concerning their density and their activity in positron emission tomography further support this hypothesis of an evolutionary model in hepatic AE lesions [ 31 , 32 , 33 ].…”

Section: Discussionmentioning

confidence: 86%

Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis

et al. 2020

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Alveolar echinococcosis (AE) is caused by the intermediate stage of Echinococcus multilocularis. We aimed to correlate computed tomography (CT) data with histology to identify distinct characteristics for different lesion types. We classified 45 samples into five types with the Echinococcus multilocularis Ulm Classification for Computed Tomography (EMUC-CT). The various CT lesions exhibited significantly different histological parameters, which led us to propose a progression model. The initial lesion fit the CT type IV classification, which comprises a single necrotic area with the central located laminated layer, a larger distance between laminated layer and border zone, a small fibrotic peripheral zone, and few small particles of Echinococcus multilocularis (spems). Lesions could progress through CT types I, II, and III, characterized by shorter distances between laminated layer and border zone, more spems inside and surrounding the lesion, and a pronounced fibrotic rim (mostly in type III). Alternatively, lesions could converge to a highly calcified, regressive state (type V). Our results suggest that the CT types mark sequential stages of the infection, which progress over time. These distinct histological patterns advance the understanding of interactions between AE and human host; moreover, they might become prognostically and therapeutically relevant.

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Section: Discussionmentioning

confidence: 86%

Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis

et al. 2020

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“…Infection caused by Echinococcus multilocularis is the most dangerous parasitic zoonosis in Europe. Left untreated, it has a very high mortality rate after located in vital organs such as liver, lungs, brain [24]. The alveolar cyst causes a maling tumor-like lesions with infiltrative, proliferative and destructive character, which locates in the liver primarily, then metastasizes to the other organs [25].…”

Section: Discussion and Conclussionsmentioning

confidence: 99%

Portal hypertension as a result of the incomplete surgically treated advanced alveolar echinococcosis: a case description

et al. 2020

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Background: Infection of Echinococcus multilocularis causes in humans the alveolar echinococcosis. Although the infection has worldwide distribution it is rarely detected. Diagnosis of alveococcosis is difficult because of not typical clinical picture and irregular results of radiological examinations suggesting neoplasmatic process which begins in the liver tissue or in the biliary tracts. The parasitic growth is slow, so the illness is quite often established in late invasion period. Treatment of long-lasting and late diagnosed infection is difficult and requires cooperation of parasitologists together with surgeons to avoid life-threatening organ dysfunction. Case presentation: We describe a young male patient, diagnosed, according to the radiological, immunological and histological examination results, infection of Echinococcus multilocularis, who was treated with not radical resection of pathologic mass together with persistent albendazole intake. The right hepatectomy was performed. In addition, visible cysts were removed from the left lobe of the liver in nonanatomical resection and suspicious calcified lesions in hepatoduodenal ligament were also removed. After the operation portal hypertension, with splenomegaly and symptoms of the liver cirrhosis occurred (thrombocytopenia, collateral venous circulation, first degree varices oesophagii). The portal hypertension probably could be a result of incomplete surgery due to extended parasitic infection and liver anathomical changes due to performed procedures, because the portal hypertension and it's further complications had not been observed before the operation. Conclusions: Echinococcus multilocularis should be taken under consideration in differential diagnosis of irregular lesions within the liver. Lon-lasting invasion could be responsible for the irreversible secondary liver changes such as cirrhosis and portal hypertension. The surgery treatment (treatment of choice) is difficult and it's results depends on the invasion period the patient is operated on. After the surgery the patient requires careful followup, to detect early complications.

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“…It forms 2-3% of liver cysts. In radiological imaging techniques, it is seen as the cyst wall makes papillary extensions into the liver parenchyma, which may resemble a hepatic tumor that leaks clinically and radiographically with irregular edges and heterogeneous density [18]. This formation is very important because if a part of the liver parenchyma is not resected in the surgery, there may remain a part of the germinative membrane which will cause recurrences ( Figure 6).…”

Section: Alveolar Cysts (E Alveolaris = E Multilocularis)mentioning

confidence: 99%

The Surgical Management of Hydatid Cyst of the Liver: What is New?

Mihmanlı¹,

Tanal²,

Bozkurt³

et al. 2020

Overview on Echinococcosis

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Liver hydatid cyst is a disease of zoonosis caused by Echinococcus granulosus or less frequently by Echinococcus multilocularis and Echinococcus oligarthrus. The primary carriers are canines, while human beings are secondary hosts. Early diagnosis is important for cysts not to become complicated and for the treatment not to get difficult. The most effective treatment of uncomplicated hydatid cyst is to reduce the dead space of the cavity and to discharge the fluid as much as possible. However, if the cysts get complex, there is no standard treatment management defined other than offered management options by authors. In complex conditions, the treatment is determined according to the stage of the cyst and the relation of the cyst with biliary ducts or surrounding organs. In this chapter, the treatment regimens of liver hydatid disease mainly based on interventions and surgical operations are going to take a part.

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Simple liver cysts and cystoid lesions in hepatic alveolar echinococcosis: a retrospective cohort study with Hounsfield analysis

Cited by 15 publications

References 39 publications

Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis

Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis

Portal hypertension as a result of the incomplete surgically treated advanced alveolar echinococcosis: a case description

The Surgical Management of Hydatid Cyst of the Liver: What is New?

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