Abstract
Among echinococcoses diseases of human interest, two have a global public health impact: cystic and alveolar echinococcosis caused by Echinococcus granulosus sensu lato and Echinococcus multilocularis, respectively. Cystic and alveolar echinococcosis are neglected infectious diseases epidemiologically and are clinically vastly different with distinct microscopic features. Because of the rareness of these zoonotic diseases, pathologists have limited diagnostic experience in the analysis of the lesions caused by Echinococcus tapeworms. Here, we describe the main microscopic features to be considered to characterize these lesions: laminated layer, central necrosis, growth pattern, and delineation from adjacent tissue. Moreover, immunohistology using monoclonal antibodies is of great diagnostic help in reaching a definitive diagnosis by identifying the laminated body and small particles of E. multilocularis (spems) and small particles of E. granulosus (spegs).
Highlights
Echinococcoses diseases are caused by larval stages of the parasitic tapeworms of the genus Echinococcus
The laminated layer of E. multilocularis, E. granulosus, and E. vogeli metacestodes mainly consists of polysaccharide protein complexes with a predominance of galactosamine over glucosamine [10]
The antigen gen recognized by the antibody is the mucin-type Em2 in the laminated layer of the recognized by the antibody is the mucin-type Em2 in the laminated layer of the E. multiE. multilocularis metacestodes
Summary
Echinococcoses diseases are caused by larval stages (metacestodes) of the parasitic tapeworms of the genus Echinococcus. A less frequent disease of human interest is neotropical echinococcosis (NE), caused by the tapeworm Echinococcus vogeli, and. In humans the lesions of the larval stage of Echinococcus spp. are mainly localized in the liver. Because NE caused by E. vogeli and E. oligarthrus is very rare and not a well-estimated human medical condition, in the following we will mainly focus on AE and CE. The main problem for the pathologist is the rareness of this disease, resulting in an exceptionally low incidence of the parasite in the daily diagnostic routine; the pathologist generally has little diagnostic experience with this lesion outside specialized and/or experienced centers. We will describe the main macroscopic and microscopic features of AE and CE in humans
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