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Schistosomiasis manifesting as a colon polyp: a case report.

Issa I, Osman M, Aftimos G - J Med Case Rep (2014)

Bottom Line: However, colon polyps associated with Schistosoma in the absence of inflammation have rarely been reported, especially in young people; this is the first case with the following presentation.A colonoscopy showed normal colonic mucosa but surprisingly a large pedunculated polyp was found in her ascending colon.She was treated with two doses of praziquantel and showed immediate marked clinical improvement.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Rafic Hariri University Hospital (RHUH), Beirut, Lebanon. Iyadissa71@gmail.com.

ABSTRACT

Introduction: Schistosomiasis is a rare disease with a common intestinal involvement. However, colon polyps associated with Schistosoma in the absence of inflammation have rarely been reported, especially in young people; this is the first case with the following presentation.

Case presentation: We describe the case of a 20-year-old Ethiopian woman living in Lebanon who presented with nonspecific abdominal symptoms. Her biochemical profile was normal in addition to the results of her stool and urine tests. A colonoscopy showed normal colonic mucosa but surprisingly a large pedunculated polyp was found in her ascending colon. Pathology revealed a hamartomatous polyp but it was full of partially calcified parasitic eggs of Schistosoma mansoni compatible with chronic schistosomiasis.

Conclusions: She was treated with two doses of praziquantel and showed immediate marked clinical improvement. This unusual case will give us the opportunity to discuss schistosomiasis, its occurrence in colon polyps, clinical significance and the various means of management.

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Related in: MedlinePlus

Ziehl–Neelsen staining of the pathology slide. These two pictures demonstrate the Schistosoma eggs after Ziehl–Neelsen coloration. Magnification A ×40, B ×200. Schistosoma mansoni eggs are elongate and possess a lateral spine. The shell is acid-fast when stained with Ziehl–Neelsen stain (arrows).
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Figure 3: Ziehl–Neelsen staining of the pathology slide. These two pictures demonstrate the Schistosoma eggs after Ziehl–Neelsen coloration. Magnification A ×40, B ×200. Schistosoma mansoni eggs are elongate and possess a lateral spine. The shell is acid-fast when stained with Ziehl–Neelsen stain (arrows).

Mentions: A 20-year-old Ethiopian woman who has lived in Lebanon for the past 3 years presented to our hospital in Beirut, Lebanon, for diffuse colicky abdominal pain and bloating of a couple of years’ duration. This was exacerbated by food intake and relieved by defecation and flatus emission. Symptoms were associated with several bouts of nausea and vomiting. She also reported constipation, with several episodes of mucous in stool, and one episode of moderate amount of fresh blood per rectum. She denied fever, anorexia or weight loss. Her blood profile was normal except for mild anemia (Table 1); the results of her urine and stools tests were also normal (Table 2). A previously done ultrasound of her abdomen had revealed no abnormalities. A colonoscopy was performed and showed normal colonic mucosa but surprisingly a large (2cm) pedunculated polyp was noted in her ascending colon (Figure 1). It was removed by snare under bipolar cautery and sent to the pathologist. The pathologist was puzzled to report a hamartomatous polyp full of partially calcified parasitic Schistosoma mansoni eggs (Figures 2 and 3). Random colonic biopsies were taken and showed completely normal mucosa.


Schistosomiasis manifesting as a colon polyp: a case report.

Issa I, Osman M, Aftimos G - J Med Case Rep (2014)

Ziehl–Neelsen staining of the pathology slide. These two pictures demonstrate the Schistosoma eggs after Ziehl–Neelsen coloration. Magnification A ×40, B ×200. Schistosoma mansoni eggs are elongate and possess a lateral spine. The shell is acid-fast when stained with Ziehl–Neelsen stain (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4196203&req=5

Figure 3: Ziehl–Neelsen staining of the pathology slide. These two pictures demonstrate the Schistosoma eggs after Ziehl–Neelsen coloration. Magnification A ×40, B ×200. Schistosoma mansoni eggs are elongate and possess a lateral spine. The shell is acid-fast when stained with Ziehl–Neelsen stain (arrows).
Mentions: A 20-year-old Ethiopian woman who has lived in Lebanon for the past 3 years presented to our hospital in Beirut, Lebanon, for diffuse colicky abdominal pain and bloating of a couple of years’ duration. This was exacerbated by food intake and relieved by defecation and flatus emission. Symptoms were associated with several bouts of nausea and vomiting. She also reported constipation, with several episodes of mucous in stool, and one episode of moderate amount of fresh blood per rectum. She denied fever, anorexia or weight loss. Her blood profile was normal except for mild anemia (Table 1); the results of her urine and stools tests were also normal (Table 2). A previously done ultrasound of her abdomen had revealed no abnormalities. A colonoscopy was performed and showed normal colonic mucosa but surprisingly a large (2cm) pedunculated polyp was noted in her ascending colon (Figure 1). It was removed by snare under bipolar cautery and sent to the pathologist. The pathologist was puzzled to report a hamartomatous polyp full of partially calcified parasitic Schistosoma mansoni eggs (Figures 2 and 3). Random colonic biopsies were taken and showed completely normal mucosa.

Bottom Line: However, colon polyps associated with Schistosoma in the absence of inflammation have rarely been reported, especially in young people; this is the first case with the following presentation.A colonoscopy showed normal colonic mucosa but surprisingly a large pedunculated polyp was found in her ascending colon.She was treated with two doses of praziquantel and showed immediate marked clinical improvement.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Rafic Hariri University Hospital (RHUH), Beirut, Lebanon. Iyadissa71@gmail.com.

ABSTRACT

Introduction: Schistosomiasis is a rare disease with a common intestinal involvement. However, colon polyps associated with Schistosoma in the absence of inflammation have rarely been reported, especially in young people; this is the first case with the following presentation.

Case presentation: We describe the case of a 20-year-old Ethiopian woman living in Lebanon who presented with nonspecific abdominal symptoms. Her biochemical profile was normal in addition to the results of her stool and urine tests. A colonoscopy showed normal colonic mucosa but surprisingly a large pedunculated polyp was found in her ascending colon. Pathology revealed a hamartomatous polyp but it was full of partially calcified parasitic eggs of Schistosoma mansoni compatible with chronic schistosomiasis.

Conclusions: She was treated with two doses of praziquantel and showed immediate marked clinical improvement. This unusual case will give us the opportunity to discuss schistosomiasis, its occurrence in colon polyps, clinical significance and the various means of management.

Show MeSH
Related in: MedlinePlus