Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis
Alveolar echinococcosis (AE) is caused by the intermediate stage of <i>Echinococcus multilocularis</i>. We aimed to correlate computed tomography (CT) data with histology to identify distinct characteristics for different lesion types. We classified 45 samples into five types with the &l...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
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MDPI AG
2020-08-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/9/8/634 |
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| author | Johannes Grimm Annika Beck Juliane Nell Julian Schmidberger Andreas Hillenbrand Ambros J. Beer Balázs Dezsényi Rong Shi Meinrad Beer Peter Kern Doris Henne-Bruns Wolfgang Kratzer Peter Moller Thomas FE Barth Beate Gruener Tilmann Graeter |
| author_facet | Johannes Grimm Annika Beck Juliane Nell Julian Schmidberger Andreas Hillenbrand Ambros J. Beer Balázs Dezsényi Rong Shi Meinrad Beer Peter Kern Doris Henne-Bruns Wolfgang Kratzer Peter Moller Thomas FE Barth Beate Gruener Tilmann Graeter |
| author_sort | Johannes Grimm |
| collection | DOAJ |
| description | Alveolar echinococcosis (AE) is caused by the intermediate stage of <i>Echinococcus multilocularis</i>. We aimed to correlate computed tomography (CT) data with histology to identify distinct characteristics for different lesion types. We classified 45 samples into five types with the <i>Echinococcus multilocularis</i> Ulm Classification for Computed Tomography (EMUC-CT). The various CT lesions exhibited significantly different histological parameters, which led us to propose a progression model. The initial lesion fit the CT type IV classification, which comprises a single necrotic area with the central located laminated layer, a larger distance between laminated layer and border zone, a small fibrotic peripheral zone, and few small particles of <i>Echinococcus multilocularis</i> (spems). Lesions could progress through CT types I, II, and III, characterized by shorter distances between laminated layer and border zone, more spems inside and surrounding the lesion, and a pronounced fibrotic rim (mostly in type III). Alternatively, lesions could converge to a highly calcified, regressive state (type V). Our results suggest that the CT types mark sequential stages of the infection, which progress over time. These distinct histological patterns advance the understanding of interactions between AE and human host; moreover, they might become prognostically and therapeutically relevant. |
| first_indexed | 2024-03-10T17:58:59Z |
| format | Article |
| id | doaj.art-dc140313a6cc40b3ab0ab10e7a5380f3 |
| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-10T17:58:59Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-dc140313a6cc40b3ab0ab10e7a5380f32023-11-20T09:03:25ZengMDPI AGPathogens2076-08172020-08-019863410.3390/pathogens9080634Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar EchinococcosisJohannes Grimm0Annika Beck1Juliane Nell2Julian Schmidberger3Andreas Hillenbrand4Ambros J. Beer5Balázs Dezsényi6Rong Shi7Meinrad Beer8Peter Kern9Doris Henne-Bruns10Wolfgang Kratzer11Peter Moller12Thomas FE Barth13Beate Gruener14Tilmann Graeter15Institute of Pathology, University Hospital of Ulm, 89081 Ulm, GermanyInstitute of Pathology, University Hospital of Ulm, 89081 Ulm, GermanyInstitute of Pathology, University Hospital of Ulm, 89081 Ulm, GermanyDepartment of Internal Medicine, University Hospital of Ulm, 89081 Ulm, GermanyDepartment of General, Visceral, and Transplantation Surgery, University Hospital of Ulm, 89081 Ulm, GermanyDepartment of Nuclear Medicine, University Hospital of Ulm, 89081 Ulm, GermanyDepartment of Infectiology, Central Hospital of Southern Pest National Institute of Hematology and Infectious Diseases, 1097 Budapest, HungaryDepartment of Diagnostic and Interventional Radiology, University Hospital of Ulm, 89081 Ulm, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Ulm, 89081 Ulm, GermanyDivision of Infectious Diseases, University Hospital and Medical Centre of Ulm, 89081 Ulm, GermanyDepartment of General, Visceral, and Transplantation Surgery, University Hospital of Ulm, 89081 Ulm, GermanyDepartment of Internal Medicine, University Hospital of Ulm, 89081 Ulm, GermanyInstitute of Pathology, University Hospital of Ulm, 89081 Ulm, GermanyInstitute of Pathology, University Hospital of Ulm, 89081 Ulm, GermanyDivision of Infectious Diseases, University Hospital and Medical Centre of Ulm, 89081 Ulm, GermanyDepartment of Diagnostic and Interventional Radiology, University Hospital of Ulm, 89081 Ulm, GermanyAlveolar echinococcosis (AE) is caused by the intermediate stage of <i>Echinococcus multilocularis</i>. We aimed to correlate computed tomography (CT) data with histology to identify distinct characteristics for different lesion types. We classified 45 samples into five types with the <i>Echinococcus multilocularis</i> Ulm Classification for Computed Tomography (EMUC-CT). The various CT lesions exhibited significantly different histological parameters, which led us to propose a progression model. The initial lesion fit the CT type IV classification, which comprises a single necrotic area with the central located laminated layer, a larger distance between laminated layer and border zone, a small fibrotic peripheral zone, and few small particles of <i>Echinococcus multilocularis</i> (spems). Lesions could progress through CT types I, II, and III, characterized by shorter distances between laminated layer and border zone, more spems inside and surrounding the lesion, and a pronounced fibrotic rim (mostly in type III). Alternatively, lesions could converge to a highly calcified, regressive state (type V). Our results suggest that the CT types mark sequential stages of the infection, which progress over time. These distinct histological patterns advance the understanding of interactions between AE and human host; moreover, they might become prognostically and therapeutically relevant.https://www.mdpi.com/2076-0817/9/8/634<i>Echinococcosis multilocularis</i>alveolar echinococcosiscomputed tomographyhistologyhumans |
| spellingShingle | Johannes Grimm Annika Beck Juliane Nell Julian Schmidberger Andreas Hillenbrand Ambros J. Beer Balázs Dezsényi Rong Shi Meinrad Beer Peter Kern Doris Henne-Bruns Wolfgang Kratzer Peter Moller Thomas FE Barth Beate Gruener Tilmann Graeter Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis Pathogens <i>Echinococcosis multilocularis</i> alveolar echinococcosis computed tomography histology humans |
| title | Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis |
| title_full | Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis |
| title_fullStr | Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis |
| title_full_unstemmed | Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis |
| title_short | Combining Computed Tomography and Histology Leads to an Evolutionary Concept of Hepatic Alveolar Echinococcosis |
| title_sort | combining computed tomography and histology leads to an evolutionary concept of hepatic alveolar echinococcosis |
| topic | <i>Echinococcosis multilocularis</i> alveolar echinococcosis computed tomography histology humans |
| url | https://www.mdpi.com/2076-0817/9/8/634 |
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