Pathomorphological and gender-age aspects of echinococosis of the liver

Abstract

Background. Echinococcosis is a chronic parasitic disease that belongs to zooanthropohelminthosis and is characterized by the development of solitary or multiple cystic formations in the liver, lungs, brain and other organs. Today, the incidence is increasing dramatically in non-endemic countries, and the spread of the disease is largely linked to global population migration. Purpose – To analyze the pathomorphological and sex-age characteristics of operated patients with echinococcosis of the liver for the period 2011–2021. Materials and Methods. Medical documentation and autopsy material of all cases of surgical intervention in patients with liver echinococcosis at the pathology department of the State Institution «Zaycev V.T. Institute of general and urgent surgery of the National Academy of Medical Sciences of Ukraine» for the period 2011–2021. Sex-age characteristics of patients with echinococcosis were studied. A pathomorphological study of the postoperative material was carried out, taking into account the size and type of cysts, and the location of their formation. The preparations were stained with hematoxylin and eosin and by the Van Gieson method. Results. During the period 2011–2021, 36 operated patients with echinococcosis were recorded. Liver echinococcosis was mostly detected in men – 52.8% (р ≤ 0.05), the average age of patients was 46.9 ± 3.1 years. Among the operated, the percentage of people under 50 was 69.4%, with a predominance of men (52%). In the case of primary and recurrent echinococcosis of the liver, single cysts were found in most patients, namely in 26 (72.2%) with predominant localization in the right lobe (88.5%). Multiple cysts were found in 10 patients (27.8%); lesions of the right lobe of the liver – 70.0%, left – 10.0%, both lobes – 20.0%. It was established that the average diameter of echinococcal cysts was 13.8 ± 2.5 cm, individual cysts reached 17 cm. The thickness of all layers of the cyst wall was 1.3 ± 0.3 cm. The outer acellular layer of the cyst wall was 0.8 ± 0.1 cm. In most cases (61.1%, p ≤ 0.05), the parasite was alive, as evidenced by the clear, colorless cyst fluid with the presence of single daughter cysts with a diameter of 0.1 to 2 cm, which had the same macro- and microscopic characteristics as the mother cyst structure The color of the entire membrane of the parasite was white-pink. Conclusions. Over a 10-year period, 36 patients operated on for echinococcosis of the liver were recorded, the majority of cases were men (52.8%, p ≤ 0.05). The average age of the patients was 46.9 ± 3.1 years and ranged from 26 to 69 years. Among those operated on, the percentage of people under 50 was 69.4%, with a predominance of males in the gender structure. In the case of primary and recurrent echinococcosis of the liver, single cysts were found in most patients, namely in 26 (72.2%) with predominant localization in the right lobe (88.5%). Multiple cysts were found in 10 patients (27.8%); lesions of the right lobe of the liver – 70.0%, left – 10.0%, both lobes – 20.0%. The average diameter of echinococcal cysts was 13.8 ± 2.5 cm, individual cysts reached 17 cm. The thickness of all layers of the cyst wall was 1.3 ± 0.3 cm. The outer acellular layer of the cyst wall was 0.8 ± 0.1 cm In most cases, the parasite was alive (61.1%, p ≤ 0.05).

Keywords

• еchinococcal cyst liver adult population