Should be Remembered in the Differential Diagnosis of Klatskin Tumour: Alveolar Echinococcosis

SummaryHuman alveolar echinococcosis (AE) is a silently-progressing disorder that has become a threat in many countries. Since 2000, when the first case was recorded, the number of human AE patients in Slovakia is on continuous raise. The article presents a rare case of alveolar echinococcosis with infiltration in the adrenal gland and discusses the problems associated with differential diagnosis of the disease. In 2016, abdominal ultrasound performed due abdominal pain complaint showed the presence of cystic lesions in the right liver lobe of 54-year old female patient. During surgery, another lesion in the right adrenal gland was found, and neoplastic processes or echinococcosis were considered in the differential diagnosis. Due to unclear correlation between radiology, serology and histopathology results and endemic situation in Slovakia, molecular examination was recommended. Subsequently E. multilocularis was confirmed as etiological agent of infection. Alveolar echinococcosis is considered as a rare disease, with very few patients referred to clinicians or hospitals that sometimes have almost none existing experience with the diagnosis and treatment of the disease. Therefore, the establishment of networks or reference centres specialized on management of the disease would be suitable way to provide the patients with the best care and improve the disease diagnosis, treatment and prognosis.

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Surgical and chemotherapeutic treatment of alveolar echinococcosis in a dog

Journal of the American Animal Hospital Association ◽

10.5326/15473317-34-4-309 ◽

1998 ◽

Vol 34 (4) ◽

pp. 309-314 ◽

Cited By ~ 13

Author(s):

M Haller ◽

P Deplazes ◽

F Guscetti ◽

JC Sardinas ◽

I Reichler ◽

...

Keyword(s):

Differential Diagnosis ◽

Potential Risk ◽

Echinococcus Multilocularis ◽

Endemic Area ◽

Alveolar Echinococcosis ◽

Surgical Removal ◽

Risk Of Infection ◽

Polycystic Liver ◽

Complete Clinical Remission ◽

Chemotherapeutic Treatment

Surgical removal of macroscopically detectable metacestode tissue followed by postoperative chemotherapy according to established human protocols resulted in complete clinical remission and immediate normalization of hyperglobulinemia in a dog with alveolar echinococcosis (AE). The disease is caused by the metacestode stage of the cestode, Echinococcus multilocularis. In endemic areas, AE should be included in the differential diagnosis of polycystic liver masses, especially if concomitant hyperglobulinemia is present. However, the importance of AE is not only the disease of the single dog itself but also the potential risk of infection for humans in an endemic area.

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Evaluation of an Enzyme-Linked Immunosorbent Assay (ELISA) with Affinity-Purified Em18 and an ELISA with Recombinant Em18 for Differential Diagnosis of Alveolar Echinococcosis: Results of a Blind Test

Journal of Clinical Microbiology ◽

10.1128/jcm.40.11.4161-4165.2002 ◽

2002 ◽

Vol 40 (11) ◽

pp. 4161-4165 ◽

Cited By ~ 36

Author(s):

A. Ito ◽

N. Xiao ◽

M. Liance ◽

M. O. Sato ◽

Y. Sako ◽

...

Keyword(s):

Differential Diagnosis ◽

Immunosorbent Assay ◽

Alveolar Echinococcosis ◽

Enzyme Linked Immunosorbent Assay ◽

Blind Test

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Importance of complex diagnostic approach in differential diagnosis of alveolar echinococcosis

Helminthologia ◽

10.1515/helmin-2015-0047 ◽

2015 ◽

Vol 52 (4) ◽

pp. 298-302 ◽

Cited By ~ 5

Author(s):

M. Szilágyiová ◽

Ľ. Laca ◽

D. Antolová ◽

E. Nováková ◽

R. Rosoľanka ◽

...

Keyword(s):

Differential Diagnosis ◽

Cystic Echinococcosis ◽

Alveolar Echinococcosis ◽

Clinical Laboratory ◽

Molecular Techniques ◽

Positive Serology ◽

Surgical Biopsy ◽

Serological Tests ◽

Larval Stages ◽

Long Time

Summary Alveolar and cystic echinococcosis, serious parasitic diseases caused by larval stages of Echinococcus multilocularis and E. granulosus has been diagnosed in Slovakia for a long time. Study presents case of 49-years old patient with accidentally diagnosed one big (60 mm) and multiple small (2 - 24 mm) hypoechogenic structures localised in right liver lobe. According to positive serology to E. granulosus antigen and results of imaging examinations the patient was classifi ed as possible case of cystic echinococcosis and treated with mebendazole. Later, due to the worsening of clinical, laboratory and CT fi ndings surgical biopsy was performed and surgical biopsy and subsequent PCR examination of liver tissue confi rmed the diagnosis of alveolar echinococosis. Clinical picture of disease imitating cystic echinococcosis in presented case report, together with results of serological tests confi rmed importance of accurate differential diagnosis of echinococcosis. Each aspect of clinical and laboratory results should be considered responsibly, however, sometimes only molecular techniques can solve the problem of differential diagnosis.

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RETRACTED ARTICLE: The diagnostic nomogram of platelet-based score models for hepatic alveolar echinococcosis and atypical liver cancer

Scientific Reports ◽

10.1038/s41598-019-55563-3 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Qiancheng Du ◽

Yanyan Wang ◽

Shihao Guan ◽

Chenliang Hu ◽

Mengxuan Li ◽

...

Keyword(s):

Differential Diagnosis ◽

Regression Analysis ◽

Liver Cancer ◽

Prediction Model ◽

Alveolar Echinococcosis ◽

Simplified Model ◽

Calibration Plot ◽

Internal Validation ◽

Hepatic Alveolar Echinococcosis ◽

Imaging Results

AbstractHepatic alveolar echinococcosis (HAE) and liver cancer had similarities in imaging results, clinical characteristics, and so on. And it is difficult for clinicians to distinguish them before operation. The aim of our study was to build a differential diagnosis nomogram based on platelet (PLT) score model and use internal validation to check the model. The predicting model was constructed by the retrospective database that included in 153 patients with HAE (66 cases) or liver cancer (87 cases), and all cases was confirmed by clinicopathology and collected from November 2011 to December 2018. Lasso regression analysis model was used to construct data dimensionality reduction, elements selection, and building prediction model based on the 9 PLT-based scores. A multi-factor regression analysis was performed to construct a simplified prediction model, and we added the selected PLT-based scores and relevant clinicopathologic features into the nomogram. Identification capability, calibration, and clinical serviceability of the simplified model were evaluated by the Harrell’s concordance index (C-index), calibration plot, receiver operating characteristic curve (ROC), and decision curve. An internal validation was also evaluated by the bootstrap resampling. The simplified model, including in 4 selected factors, was significantly associated with differential diagnosis of HAE and liver cancer. Predictors of the simplified diagnosis nomogram consisted of the API index, the FIB-4 index, fibro-quotent (FibroQ), and fibrosis index constructed by King’s College Hospital (King’s score). The model presented a perfect identification capability, with a high C-index of 0.929 (0.919 through internal validation), and good calibration. The area under the curve (AUC) values of this simplified prediction nomogram was 0.929, and the result of ROC indicated that this nomogram had a good predictive value. Decision curve analysis showed that our differential diagnosis nomogram had clinically identification capability. In conclusion, the differential diagnosis nomogram could be feasibly performed to verify the preoperative individualized diagnosis of HAE and liver cancer.

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Primary calcified hydatid cyst of the brain

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.71729 ◽

2010 ◽

Vol 01 (02) ◽

pp. 115-117 ◽

Cited By ~ 4

Author(s):

Devendra K Tyagi ◽

Srikant Balasubramaniam ◽

Hemant V Sawant

Keyword(s):

Differential Diagnosis ◽

Hydatid Cyst ◽

Cyst Wall ◽

Alveolar Echinococcosis ◽

Indian Subcontinent ◽

Treatment Modalities ◽

Total Excision ◽

Intractable Seizures ◽

The Brain ◽

Antiparasitic Treatment

ABSTRACTCerebral hydatid disease is very rare, and in non-endemic areas like India, the occurrence is as low as 0.2% of all intracranial space occupying lesions. Calcification of the cyst wall indicates an even rarer subvariety, i.e., alveolar echinococcosis (AE). AE has hitherto been unreported in the Indian subcontinent. We report such a case in a 25-yearold male, a shepherd by occupation, who presented to us with intractable seizures and headache. He had no gross lesion in the liver. Craniotomy with total excision of the lesion was performed, followed by antiparasitic treatment. The radiological presentation, differential diagnosis and treatment modalities are discussed in relation to our case.

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Tumor Diagnosis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100053966 ◽

1982 ◽

Vol 40 ◽

pp. 262-265

Author(s):

Bruce Mackay

Keyword(s):

Electron Microscopy ◽

Transmission Electron Microscopy ◽

Differential Diagnosis ◽

Light Microscopy ◽

Clinical Examination ◽

Ultrastructural Study ◽

Diagnostic Procedures ◽

Specific Diagnosis ◽

Transmission Electron ◽

Microscopic Diagnosis

The broadest application of transmission electron microscopy (EM) in diagnostic medicine is the identification of tumors that cannot be classified by routine light microscopy. EM is useful in the evaluation of approximately 10% of human neoplasms, but the extent of its contribution varies considerably. It may provide a specific diagnosis that can not be reached by other means, but in contrast, the information obtained from ultrastructural study of some 10% of tumors does not significantly add to that available from light microscopy. Most cases fall somewhere between these two extremes: EM may correct a light microscopic diagnosis, or serve to narrow a differential diagnosis by excluding some of the possibilities considered by light microscopy. It is particularly important to correlate the EM findings with data from light microscopy, clinical examination, and other diagnostic procedures.

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The Preschool Stuttering Screen for Health Care Professionals

Perspectives on Fluency and Fluency Disorders ◽

10.1044/ffd21.2.59 ◽

2011 ◽

Vol 21 (2) ◽

pp. 59-62

Author(s):

Joseph Donaher ◽

Christina Deery ◽

Sarah Vogel

Keyword(s):

Risk Factors ◽

Health Care ◽

Differential Diagnosis ◽

Preschool Children ◽

Health Care Professionals ◽

Healthcare Professionals ◽

Evidence Based ◽

Developmental Profile

Healthcare professionals require a thorough understanding of stuttering since they frequently play an important role in the identification and differential diagnosis of stuttering for preschool children. This paper introduces The Preschool Stuttering Screen for Healthcare Professionals (PSSHP) which highlights risk factors identified in the literature as being associated with persistent stuttering. By integrating the results of the checklist with a child’s developmental profile, healthcare professionals can make better-informed, evidence-based decisions for their patients.

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