blok neopl s haematobium11

7/27/2019 Blok NEOPL S Haematobium11

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BLOK NEOPLASIA

TREMATODA DARAH:

Schistosoma haematobium




Geographic Distribution :

• Africa (54 countries) , ex: Egypt, Sudan,

Zambia, Malawi, and Zimbabwe,

•

Eastern Mediterranean• 180 million people live in endemic areas and

90 million are infected with the parasites



• Hospes definitif:

–Manusia, Baboon dan sejenisnya

• causes urinary schistosomiasis,

(schistosomal hematuria,vesical

schistosomiasis, or urinary bilharziasis)



source: http://www.dpd.cdc.gov/dpdx/HTML/Schistosomiasis.htm



Pathogenesis & Clinical symptom :

• skin rash at site of cercarial penetration

(swimmer’s itch)

• it is the eggs not the adult flukes which are

responsible for the clinical features

• egg deposits in the bladder mucosa and

submucosa were seen during the acute phase• Continuous aggravation in the bladder

wall leads to carcinoma of the bladder



Pathogenesis ( cont’d)

•damage to the bladder or ureters :obstructed and the bladder wall thickened

• abnormal bladder function with painful

frequent urination, urinary infection

(cystitis )

•

eventually kidney damage.• hematuria is the most characteristic

symptom.



The Relationship Between Schsitosomiasis

and Bladder cancer

• Prevalence :

– Carcinoma of the urinary bladder is the

most common malignancy in the Middle

East and parts of Africa where

schistosomiasis haematobium is a

widespread problem

– The major histological cell type of bladder

cancer is Squamous Cell Carcinoma



Cancer of the bladder

• In Egypt : 60 % of the Egyptian population is at

risk of infection.

Prevalence of 37 to 48% with high incidence

• In Iraq : The proportion of SCC varied from

54 to 81% of all bladder cancer cases in

different areas of endemic infection, which

contrasts to Western countries, where the

frequency of SCC in bladder cancer cases is

much lower (3 to 10%)



Cancer of the Bladder

• eggs can act as a mechanical irritant to theurothelium

• it was also found that endogenous levels of

host

cell DNA damage were related to theintensity of infection.

• chronic inflammatory lesions

continuous exposure to the carcinogens,

e.g.,N-nitroso compounds, which were detected in

larger quantities in the urine of patients with

schistosomiasis



Control

Treated Mice

Histo-pathological changes



Epidemiology

• Age and Gender Ratios :

• In schistosome-free countries : the peak incidence

of bladder cancer is in the 6 th or 7 th decade ( max

between the ages of 65 and 75 years)• By contrast, in endemic countries : the mean age is

between 40 and 49 years

•

The ratio of bladder cancer

incidence (males tofemales) in countries with endemic infection was

reported to be 5:1



LABORATORY DIAGNOSIS:

• Specific :

• Finding the eggs or occasionally the hatched

miracidia in the urine

• occasionally, eggs can be found in faeces

• detecting eggs in rectal biopsy or bladder

mucosal biopsy



Biopsy of the mucosal bladder

http://aapredbook.aappublications.org/content/images/large/2009/1/118_05.jpeg

http://aapredbook.aappublications.org/cgi/content/full/2009/1/3.119/118_18

blok neopl s haematobium11

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