Blok NEOPL S um

8/2/2019 Blok NEOPL S um

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BLOK NEOPLASIA

TREMATODA HATI :

Clonorchis sinensis

Opisthorchis viverrini

TREMATODA DARAH:

Schistosoma haematobium


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Geographic Distribution :

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

Zambia,Malawi, and Zimbabwe,

Eastern Mediterranean


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Hospes definitif:

Manusia, Baboon dan sejenisnya

causes urinary schistosomiasis,

(schistosomal hematuria,vesical

schistosomiasis, or urinary bilharziasis)


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telur


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Pathogenesis & Clinical symptom :

skin rash at site of cercarial penetration

(swimmers 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


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Pathogenesis ( contd)

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.


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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 haematobiumis a

widespread problem

The major histological cell type of bladder

cancer is Squamous Cell Carcinoma


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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 allbladder cancer cases in

different areas of endemic infection,which

contrasts to Western countries, where the

frequency of SCCin bladder cancer cases is

much lower (3 to 10%)


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Cancer of the Bladder

eggs can act as amechanical irritant to theurothelium

it was also found that endogenous levels of

host

cell DNA damage were related to theintensity of infection.

chronic inflammatorylesions

continuous exposure to the carcinogens,

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

larger quantitiesin the urine of patients with

schistosomiasis


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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 tofemales) in countries with endemic infectionwas

reported to be 5:1


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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


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Biopsy of the mucosal bladder
http://aapredbook.aappublications.org/content/images/large/2009/1/118_05.jpeghttp://aapredbook.aappublications.org/cgi/content/full/2009/1/3.119/118_18

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