Atlas of Parasitic Pathology

Dedicated to Prof. H. M . Seitz, M D and Prof. U. Pfeifer, M D ,

University of Bonn , Germany, whose help in complet ing this atlas is very much appreciated

Current Histopathology

Consultant Editor Professor G. Austin Gresham, TD, ScD, MD, FRCPath. Professor of Morbid Anatomy and Histology, University of Cambridge

Volume Twenty

PARASITIC PATHOLOGY By K. SALFELDER Prof. Titular Laboratorio de Investigacion en Patologia Facultad de Medic ina Universidad de Los Andes, Mer ida, Venezuela S A

Assisted by

T. R. de Liscano Prof. Titular and

E. Sauerteig Profesor Asesor Laboratorio de Investigacion en Patologia Facultad de Medic ina Universidad de Los Andes, Merida Venezuela S A

SPRINGER SCIENCE+BUSINESS MEDIA, B.V.

A catalogue record for this book is available from the British Library.

I S B N 9 7 8 - 9 4 - 0 1 0 - 4 9 8 8 - 7

Library of Congress Cataloging in Publ icat ion Data

Copyr ight

© 1992 by Sp r i nge r S c i e n c e + B u s i n e s s M e d i a Dordrecht Or ig inal ly pub l i shed by K luwer A c a d e m i c P u b l i s h e r s in 1992

A l l rights reserved. No part of this publ icat ion may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical , pho tocopy ing , recording or otherwise, wi thout prior permission from the publ ishers, Kluwer Academic Publ ishers BV, PO Box 17, 3300 A A Dordrecht, The Netherlands.

Salfelder, Karlhanns, 1 9 1 9 -At las of parasitic pathology / by K. Salfelder ;

assisted by T.R. de L iscano and E. Sauerteig, p. cm. — (Current h istopathology ; v. 20)

Includes bibl ioaraphical references and index. I S B N 9 7 8 - 9 4 - 0 1 0 - 4 9 8 8 - 7 I S B N 9 7 8 - 9 4 - 0 1 1 - 2 2 2 8 - 3 (eBook) DOI 1 0 . 1 0 0 7 / 9 7 8 - 9 4 - 0 1 1 - 2 2 2 8 - 3

1. Parasitic diseases — At lases. 2. Parasit ic d i s e a s e s — H i s t o p a t h o l o g y — At lases. I. L iscano, T. R. de. II. Sauerteig, Eberhard. III. Title. IV. Series.

[ D N L M : 1. Parasitic Diseases — pathology — atlases. W1 C U 7 8 8 J B A v. 20 / W C 17 S163ac ] R C 1 1 9 . S 2 4 1992 616.9 '607 — dc20 D N L M / D L C for Library of Congress 9 2 - 4 9 7 9 0

CIP

Contents

Consultant editor's note 7 26 Toxocariasis 115 27 Anisakiasis 115

Preface 8 28 G nathostom iasis 117 29 Angiostrongylosis 119

Parasitic diseases 9 30 Capillariasis 124 31 Dracunculosis 124

II Protozoan diseases 13 Filaria infections 126

Haemoflagellate infections 13 32 Filariasis 126 1 American trypanosomiasis 13 33 Loiasis 128 2 African trypanosomiasis 23 34 Onchocerciasis 131

Leishmaniases 26 35 Dirofilariasis 135 3 Cutaneous leishmaniasis 27 36 Rare and uncommon nematodiases 137 4 Mucocutaneous leishmaniasis 27 37 Larva migrans 138 5 Visceral leishmaniasis 35 B. Cestodiasis 141 6 Giardiasis 39 38 Taeniasis 141 7 T richomon iasis 41 39 Diphyllobothriasis 143 8 Amoebiasis 43 40 Dipylidiasis 145 9 Acanthamoebiasis 49 41 Hymenolepiasis 145

10 Blastocystis infection 56 42 Cysticercosis 147 11 Toxoplasmosis 59 43 Echinococcosis 148 12 Babesiosis 69 13 Sarcosporidiosis 72 C. Trematodiasis 151 14 Isosporosis 73 44 Blood fluke infection 151 15 Cryptosporidiosis 76 45 Lung trematode infection 160 16 Malaria 77 46 Liver trematode infection 163 17 Pneumocystosis 85 47 Intestinal fluke infections 169 18 Balantidiasis 91

D. Worm eggs 171 19 M icrosporidiosis 94

III Helminthic diseases 96 IV Disorders caused by arthropods 173

A. Nematodiasis 96 48 Scabies 173 20 Enterobiasis 97 49 Demodicidosis 175 21 Ascariasis 100 50 Tungiasis 178 22 Trichuriasis 101 51 Myiasis 181 23 Uncinariasis 106 52 Pentastomiasis 184 24 Strongyloidiasis 109 25 Trichinosis 112 Index 186

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Current Histopathology Series

Already published in this series: Volume 1 Atlas of Lymph Node Pathology Volume 2 Atlas of Renal Pathology Volume 3 Atlas of Pulmonary Pathology Volume 4 Atlas of Liver Pathology Volume 5 Atlas of Gynaecological Pathology Volume 6 Atlas of Gastrointestinal Pathology Volume 7 Atlas of Breast Pathology Volume 8 Atlas of Oral Pathology Volume 9 Atlas of Skeletal Muscle Pathology Volume 10 Atlas of Male Reproductive Pathology Volume 11 Atlas of Skin Pathology Volume 12 Atlas of Cardiovascular Pathology Volume 13 Atlas of Experimental Toxicological Pathology Volume 14 Atlas of Serous Fluid Cytopathology Volume 15 Atlas of Bone Marrow Pathology Volume 16 Atlas of Ear. Nose and Throat Pathology Volume 17 Atlas of Fungal Pathology Volume 18 Atlas of Synovial Fluid Cytopathology Volume 19 Tumours of the Mediastinum

Other volumes currently scheduled in this series include the fol/owing titles

Atlas of AI DS Pathology

Atlas of Bone Tumours

Atlas of Neuropathology

Atlas of Endocrine Pathology

Atlas of Ocular Pathology

Atlas of Renal Transplantation Pathology

Atlas of Soft Tissue Pathology

Biopsy of Bone in Internal Medicine

Paediatric Neoplasia

Consultant Editor's Note

At the present time books on morbid anatomy and histopathology can be divided into two broad groups: extensive textbooks often written primarily for students and monographs on research topics.

This takes no account of the fact that the vast majority of pathologists are involved in an essentially practical field of general diagnostic pathology providing an important service to their clinical colleagues. Many of these pathol­ogist are expected to cover a broad range of disciplines and even those who remain solely within the field of histopathology usually have single and sole responsibility within the hospital for all this work. They may often have no colleagues in the same department. In the field of histopathology, no less than in other medical fields, there have been extensive and recent advances, not only in new histochemical techniques but also in the type of specimen provided by new surgical procedures.

There is a great need for the provision of appropriate information for this group. This need has been defined in the following terms:

1. It should be aimed at the general clinical pathologist

7

or histopathologist with existing practical training, but should have value for the trainee pathologist.

2. It should concentrate on the practical aspects of histopathology taking account of the new techniques which should be within the compass of the worker in a unit with reasonable facilities.

3. New types of material, e.g. those derived from endo­scopic biopsy should be covered fully.

4. There should be an adequate number of illustrations on each subject to demonstrate the variation in appear­ance that is encountered.

5. Colour illustrations should be used wherever they aid recognition.

From time to time histopathologists encounter objects in histological preparations and in cytological smears that may be of parasitic origin. This book is a comprehensive, well illustrated aid to such diagnostic problems.

G. A. Gresham

Preface

One large chapter of this atlas is, in some ways, a second, enlarged and improved, edition of an atlas published some years ago 1. The Atlas of Parasitic Pathology concentrates intentionally on the main features of gross pathology and the histopathology of these diseases.

I n the four subchapters of each section on a particular parasite, the text is always arranged in the same order (Introduction, The Parasite, Pathogenesis and Pathol­ogy); thus, information can easily be found by the reader. Under 'Introduction', general data are summarized in a few sentences. Under 'Pathology', organ involvement gross pathology and morphology ofthe aetiological agent are followed by tissue reaction and differential diagnosis.

Several unpublished data and illustrations, as well as personal observations and ideas, are included because we have not published in journals for the last 15 years.

History, epidemiology, clinical data, therapy etc. are not included. Medical students may find these details in the 10th volume of the GKM2.

In another atlas in this series, differential diagnosis of micro-organisms and non-living structures in tissues has been focused on extensively3. For this reason, differential diagnosis of parasites will be discussed here only briefly.

Since the technical terms will be explained in the text or in footnotes, a glossary was considered superfluous.

This atlas is directed to pathologists and should be used as a bench manual to be kept near their microscopes for immediate consultation. Obviously, physicians and

ACKNOWLEDGEMENTS I am very grateful to many of my colleagues and friend­swho gave me material and photographs to illustrate this atlas. Thanks go first to my friends in Merida and Venezuela: R. Alvarado, A. D. de Arriaga, K. Brass, E. Carrero, W. Diaz, R. Hernandez Perez, A. L. C. de Tirado, G. Volcan and R. Zabala. My good friends, H. D. Eberhard, M. Okudaira, P. Ravisse, S. Stefanko, C. Thomas, H. Werner, and others have helped in many ways. Professor G. Piekarski of Bonn was kind enough to give permission to use some of his plates of the developmental cycles of parasites.

As always, Oswaldo Juergenson, Merida was an invalu­able help with photography.

The publishers, Oscar Todtmann, C. A. Caracas/Vene­zuela, Schattauer-Verlag, Stuttgart FRG and Schwer­Verlag, Stuttgart FRG, have permitted us to reproduce previously published illustrations. We would like to express our special gratitude to them.

The CONICIT (Consejo Nacional de Investigaciones Cientificas y Tecnol6gicas) in Caracas and the CDCHT

8

professionals of all natural and paramedical sciences, as well as teachers at all levels, may find it useful.

The first main chapter (I) deals with parasitic diseases in general, and definitions of parasites and parasitic infections. Also, data on hosts and transmission are summarized. The principal characteristics of parasitic disorders, in contrast to other infectious diseases, and all the important pathogenic parasites for men, are listed. The important parasitoses in immunodeficient patients are mentioned.

In the following three main chapters (II-IV), protozoan and helminthic diseases, as well as disorders caused by arthropods, are discussed and illustrated.

Principal worm eggs and arthropods are illustrated. Schematic drawings facilitate the understanding of the life-cycle and evolutional stages of parasites, the portal of entry and pathogenesis.

References 1. In Spanish: Salfelder, K. (1985). Las Protozoonosis en el Hombre.

Oscar Todtmann, C. A. Caracas/Venezuela, and in English: Salfelder, K. (1987). Protozoan Infections in Man. Schwer-Verlag, Stuttgart/ FRG

2. Thomas. C. (1990). Grundlagen der Klinischen Medizin. Schattauer­Verlag. Stuttgart/FRG

3. Salfelder. K. (1990). Atlas of Fungal Pathology. Vol. 17, Current Histopathology. Kluwer Academic Publishers, Lancaster

(Consejo de Desarollo Cientifico, Humanistico y Tecno-16gico) of the University of the Andes, Merida/Venezuela have subsidized several research projects of the authors. partially related to this atlas.

The academic Vice-rector of our University, Prof. Carlos Guillermo Cardenas MD, helped us to finish this atlas. The ex-rector, Prof. Pedro Rinc6n Gutierrez MD, founded our laboratory and gave us support in many ways.

The DAAD (Deutscher Akademischer Austauschdienst) of the FRG helped indirectly to finish both atlases in this series written by us.

Professor H. M. Seitz MD and Professor U. Pfeifer MD from Bonn, Germany assisted, in several ways. the final phases of the drafting of this atlas and therefore it is dedicated to these good friends.

Professor G. Austin Gresham of Cambridge. UK was kind enough to help with the 'German' English. Thank you, indeed. Professor Gresham.

Last but not least co-operation with Phil Johnstone. the editor of this atlas. was superb.