Hepatobiliary and pancreatic: Commentary

Abstract

Journal of Gastroenterology and HepatologyVolume 17, Issue 10 p. 1129-1129 Free Access Hepatobiliary and pancreatic: Commentary First published: 22 September 2009 https://doi.org/10.1046/j.1440-1746.2002.t01-1-02866.xAboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat INTERPRETATION OFFIGURE 1(SEE PAGE 1118) On the ultrasound study, the liver parenchyma shows hyperechoic bands of variable thickness (→, Fig. 1). The band near the posterior surface is very thick. These findings are typical of Schistosomiasis japonica and represent fibrosed portal tracts.1, 2 The liver biopsy showed portal inflammation and fibrosis with deposited ova (Fig. 2). Figure 2Open in figure viewerPowerPoint Liver biopsy. Ova are partially calcified. Diagnosis: chronic hepatic schistosomiasis japonica The hepatic effects of Schistosoma japonicum and S. mansoni differ both pathologically and radiologically. Schistosoma japonicum lays approximately 20 times as many ova as S. mansoni. These ova are laid in large aggregates and evoke an inflammatory response with portal fibrosis. However, lobular architecture is maintained and liver function tests are usually normal. The ultrasound pattern of portal fibrosis may be linear bands as in this case, but another common appearance is a network pattern variously described as ‘fish-scale’, crisscross or mosaic. This appearance is illustrated in Figure 3 (different case) and is because of branching fibrotic septa. Fibrosis is often more prominent near the liver capsule. Rarely, patients with advanced S. japonica have calcified fibrosis on a plain abdominal radiograph.3 In S. mansoni, portal fibrosis is more localized and may have a ‘pipestem’ appearance on cross-section. This ‘pipestem’ fibrosis is very uncommon in S. japonicum. Figure 3Open in figure viewerPowerPoint Another case of Schistosomiasis japonica showing crisscrossing bands. References 1 Okuda K. Hepatic schistosomiasis. In: Okuda K, Mitchell D, Itai Y, Ariyama J, eds. Hepatobiliary Diseases—Pathophysiology and Imaging. Oxford: Blackwell Science, 2001; 560– 9. Web of Science®Google Scholar 2 Cheung H, Lay YM, Loke TKL et al. The imaging diagnosis of hepatic schistosomiasis japonicum sequelae. Clin. Radiol. 1996; 51: 51– 5.CrossrefCASPubMedWeb of Science®Google Scholar 3 Okuda K, Jinnouchi S, Arakawa M et al. Generalized calcification of the liver in advanced schistosomiasis japonica: a case report. Acta Hepatol. Gastroenterol. 1975; 22: 98– 102. CASPubMedWeb of Science®Google Scholar Volume17, Issue10October 2002Pages 1129-1129 FiguresReferencesRelatedInformation