Download - Blok NEOPL S haematobium.ppt
BLOK NEOPLASIA
TREMATODA HATI :Clonorchis sinensis
Opisthorchis viverrini
TREMATODA DARAH:Schistosoma haematobium
Schistosoma haematobiumGeographic Distribution :• Africa (54 countries) , ex: Egypt, Sudan,
Zambia, Malawi, and Zimbabwe, • Eastern Mediterranean
• Hospes definitif:–Manusia, Baboon dan sejenisnya
• causes urinary schistosomiasis, (schistosomal hematuria,vesical
schistosomiasis, or urinary bilharziasis)
Schistosoma haematobium
telur
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 the urothelium• it was also found that endogenous levels of host cell
DNA damage were related to the intensity 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
Epidemiologi
• 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 to females) 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