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Case Reports
. 2014 Oct 8:8:331.
doi: 10.1186/1752-1947-8-331.

Schistosomiasis manifesting as a colon polyp: a case report

Iyad Issa  1 , Mona Osman, Georges Aftimos
Affiliations
Case Reports

Schistosomiasis manifesting as a colon polyp: a case report

Iyad Issa et al. J Med Case Rep. .

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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Figures

Figure 1
Figure 1
Endoscopic appearance of the polyp. The colonoscopy showed a large narrow-based pedunculated polyp in the ascending colon.
Figure 2
Figure 2
Hematoxylin and eosin staining of the pathology slide. The submitted sample is a polypoid formation measuring 1.8×0.8×0.6cm with a short pedicle. The performed cuts (A, B, C, D) are stained with hematoxylin and eosin; magnification ×25. They show a benign hamartomatous polyp, containing multiple partially calcified schistosoma eggs (1); the stroma contains smooth muscular fibers (2) intermingled with the branching and variably oriented glands (3); these glands are lined by intestinal-type epithelium with predominant goblet cells and few paneth cells at the bottom of these glands.
Figure 3
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).
See this image and copyright information in PMC

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