Hepatic alveolar echinococcosis: a diagnostic challenge

Yapici, Ozge; Ertürk, Şükrü Mehmet; Ulusay, M; Özel, Alper; Halefoğlu, Ahmet Mesrur; Karpat, Zeki; Başak, Muzaffer

doi:10.5334/jbr-btr.479

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…As extrahepatic hydatid involves multiple organs and CT scan is fast and inexpensive, and diagnosing the image of AE is comparable to MRI. A standard of care should be established for extrahepatic AE disease; A study recommend a MSCT scan from the head to the pelvis [15].…”

Section: Discussionmentioning

confidence: 99%

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Extrahepatic Alveolar Echinococcus on Multi-slice Computed Tomography and Magnetic Resonance Imaging

Guo

Liu

Wang

et al. 2021

Preprint

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Background. Alveolar echinococcus (AE) is a severe health problem in endemic areas. In recent years, the incidence of this disease in China has been increasing. The study was designed to illustrate the multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) features of extrahepatic AE.Methods. A cohort of 33 patients who suffered from extrahepatic AE was enrolled consecutively from January 2012 to December 2017. The MSCT and MRI features of extrahepatic AE were recorded and analyzed by experienced radiologists. The MSCT and MRI agreements for detecting imaging features of extrahepatic AE were calculated using kappa statistics.Results. All cases secondary to hepatic AE, except two primary extrahepatic AE, were found in this study. Locations of extrahepatic AE included 19 (57.6%) lung, 10 (30.3%) adrenal gland, 9 (27.3%) brain, 5 (15.2%) peritoneal cavity, 5 (15.2%) spleen, 4 (12.1%) diaphragm, 3 (9.1%) kidney, 3 (9.1%) retroperitoneal, and 2 (6.1%) vertebra; Involvement of 1 (3.0%) heart, 1 (3.0%) mediastinum, 1 (3.0%) muscle, and 1 (3.0%) pancreas was rare. AE of the lung usually appeared as irregular and scattered nodules with small vacuoles or cavities inside and peripheral distribution. Multiple cerebral nodules with calcification and surrounding edema were the most common features seen in brain AE. Adrenal gland AE presented as plaques containing different sizes of hypodense areas and different amounts of calcification. Injection of contrast medium showed no enhancement of lesions except in the brain. Very good agreements were seen between MSCT and MR for detecting number (κ=0.841, p=0.000), border (κ=0.911, p=0.000) and size (κ=0.864, p=0.000) of extrahepatic AE.Conclusions. MSCT and MRI are reliable imaging methods for the diagnosis of extrahepatic AE. When one AE patient is clinically confirmed, MSCT scan from the head to pelvis should be performed to exclude other organs AE.

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Section: Discussionmentioning

confidence: 99%

“…In the literature, some cases of hepatic AE have been reported [3,[11][12][13][14]. However, extrahepatic AE was just described sporadically [15,16]. The diagnosis of extrahepatic AE is a challenge even for the experienced examiner because of low human prevalence levels.…”

Section: Introductionmentioning

confidence: 99%

Extrahepatic Alveolar Echinococcus on Multi-slice Computed Tomography and Magnetic Resonance Imaging

Guo

Liu

Wang

et al. 2021

Preprint

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“…1 Human beings are accidental hosts, who become infected by ingestion of plants or water, which are contaminated by eggs of E. multilocularis or by contact with the host. 2 Liver is the most common site of infection. 3 Diagnosis is made with the help of imaging, serology, histopathology and detection of parasite nuclei acids.…”

Section: Discussionmentioning

confidence: 99%

Large Heterogeneous Calcified Masses in Liver: A Diagnostic Dilemma

Prabhakar

Kalra

Behera

et al. 2017

Journal of Clinical and Experimental Hepatology

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“…Cells of the larval tissue frequently detach and disseminate via lymph nodes and blood vessels, thus leading to metastasis in large parenchymatous organs. Therefore, AE is often compared with a slow-growing liver cancer [3]. We present here a case of esophageal variceal bleeding due to portal hypertension and cholestasis secondary to AE.…”

Section: Introductionmentioning

confidence: 99%

Portal hypertension and cholestasis due to Echinococcus alveolaris: a case report

Seçkin¹,

Çağın²,

Yıldırım³

et al. 2016

Med-Science

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Alveolar ecchinococcosis (AE) is a rare but potentially life-threatening serious parasitic disease. The parasit may involve liver and, most importantly, expand vessels and biliary tract. We present here a case of esophageal variceal bleeding due to portal hypertension and cholestasis secondary to AE. We present the case of a 30-year-old female patient who was admitted to emergency service with hematemesis, melena and icter. Upper gastrointestinal endoscopy revealed gastroesophageal varices and portal gastropathy. Contrasted computerized tomography examination showed a solid calcific lesion (cross dimension 6x11 and 5x9 cm.) of biliary tracts causing dilatation. An USG guided biopsy from the mass was performed and histological examination revealed AE. We also review here the literature on portal hypertension and cholestasis due to Echinococcus alveolaris. AE is rare a disease and may cause severe complications. Endoscopic and percutaneous drainage for biliary obstruction caused by hepatic AE has a palliative effect even in the late stages. Liver transplantation was recommended but this operation was not performed for living donor shortage. Liver transplantation should be considered in the management of advanced liver alveolar echinococcosis.

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Hepatic alveolar echinococcosis: a diagnostic challenge

Cited by 4 publications

References 16 publications

Extrahepatic Alveolar Echinococcus on Multi-slice Computed Tomography and Magnetic Resonance Imaging

Extrahepatic Alveolar Echinococcus on Multi-slice Computed Tomography and Magnetic Resonance Imaging

Large Heterogeneous Calcified Masses in Liver: A Diagnostic Dilemma

Portal hypertension and cholestasis due to Echinococcus alveolaris: a case report

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