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https://www.arca.fiocruz.br/handle/icict/14658
HEPATIC CONNECTIVE TISSUE CHANGES IN HEPATOSPLENIC SCHISTOSOMIASIS
Pipe-stem fibrosis
Schistosomiasis
Hepatosplenir disease
Collagen degradation
Affilliation
Fundação Gonçalo Moniz, Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Roberto Santos Central Hospital. Salvador, BA, Brasil
Institut Pasteur. Lyon, France
Institut Pasteur. Lyon, France
Roberto Santos Central Hospital. Salvador, BA, Brasil
Institut Pasteur. Lyon, France
Institut Pasteur. Lyon, France
Abstract
Destruction of intrahepatic portal vein branches with dispersion
of smooth muscle cells into the periportal fibrosis and preservation
of arterial and ductal structures were the main characteristic findings
seen in 66 surgical liver biopsies from patients with the hepatosplenic
form of schistosomiasis. Besides these diagnostic features,
the present histologic, immunocytochemical, and ultrastructural
study revealed the presence of a complex matrix forming the portal
and septal fibrosis in advanced schistosomiasis. There was marked
hyperplasia of elastic tissue, presence of several collagen isotypes
(I, III, procollagen III, IV, and V), actin. desmin, fibronectin, and
laminin in a richly vascularized connective tissue. Signs of multifocal
matrix (collagen) degradation were observed both at light and electron
microscopic levels, suggesting a predominance of a fibrolytic
process, at the time parasite-related lesions had almost disappeared.
The latter findings are related to the involution of periportal fibrosis
now being observed in patients who have undergone antischistosomal
chemotherapy. They exemplify morphologic changes connected
with chronic collagen degradation in human schistosomiasis
that are similar to those first seen in experimental material. Evidence
of either persistent or active chronic hepatitis was seen in several
cases but its etiology could not be determined.
Keywords
Periportal fibrosisPipe-stem fibrosis
Schistosomiasis
Hepatosplenir disease
Collagen degradation
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