Spectrum of Histopathological Diagnosis of Schistosomiasis as a Systemic Parasitic Infection in the North-West Nigeria

Abstract

Introduction: Schistosomiasis is one of the neglected tropical diseases transmitted by freshwater snail in the slowmoving water of tropical rivers and ranks second among the most widespread parasitic disease in various nations in sub-Saharan Africa. Methodology: This is a 10-year retrospective study of all cases of schistosomiasis seen in the Department of Anatomic Pathology, Usmanu Danfodiyo University Teaching Sokoto between January 2008 and December 2017. All the cases of schistosomiasis diagnosed was retrieved from the surgical pathology register. The patients' biodata and symptoms was retrieved from patients' folder. The specimens were processed with 10% Neutral buffered formalin, stained with Haematoxylin and Eosin and reported by the pathologist at the study centre. The 2016 WHO classification of the urinary system and male genital organs were used to classify the tumours. Results: A hundred and fifty-nine patients were analysed with schistosomiasis of varying systems range from gastrointestinal, prostate, genitourinary and 38 cases of malignancies of the urinary bladder with associated schistosomiasis and prostate. In the gastrointestinal system, the appendiceal schistosomiasis accounted for 21(80.8%), rectum 3 (11.5%) and sigmoid colon 2 cases (7.7%). Benign prostatic hyperplasia with schistosomiasis accounted for 1 case (25.0%) while 3 cases (75.0%) of prostatic adenocarcinoma with schistosomiasis showed age range of 45 to 78 years. There are one hundred and eleven (111) cases of urinary bladder schistosomiasis which accounted for 86.0%, male to female ratio of 10:1 and age range from 9.0 to 78.0 years. There are 27 cases of invasive squamous cell carcinoma of the urinary bladder associated with schistosomiasis accounted for 65.8% while adenocarcinoma showed 4 cases (9.7%). Moderately differentiated SCC accounted for the largest degree of tumour differentiation associated with schistosomiasis accounted for 69.6%. Terminal haematuria is the most common symptom of urinary bladder schistosomiasis accounted for 102 cases (64.2%), followed by suprapubic abdominal pain 52 (32.5%), weight loss 30 (18.9%) for patients with malignancy Conclusion: Schistosomiasis is a public health disease in endemic regions in African countries with proper documentation on the its pathogenesis, risk factors and effective treatment and complications if left untreated. Thus, mobilization of appropriate resources to help the vulnerable in order to reduce morbidity and mortalities is very crucial.