• Users Online: 253
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Contacts Login 


 
 Table of Contents  
PATHOLOGY CORNER
Year : 2021  |  Volume : 13  |  Issue : 1  |  Page : 41-42

Image quiz: A bladder biopsy from a child with hematuria


Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA

Date of Submission09-Jan-2021
Date of Acceptance13-Jan-2021
Date of Web Publication10-Apr-2021

Correspondence Address:
Prof. Samir Kahwash
Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmbs.ijmbs_4_21

Rights and Permissions

How to cite this article:
Kahwash S. Image quiz: A bladder biopsy from a child with hematuria. Ibnosina J Med Biomed Sci 2021;13:41-2

How to cite this URL:
Kahwash S. Image quiz: A bladder biopsy from a child with hematuria. Ibnosina J Med Biomed Sci [serial online] 2021 [cited 2021 May 5];13:41-2. Available from: http://www.ijmbs.org/text.asp?2021/13/1/41/313511




  Clinical Context Top


[Figure 1]. Is an H&E stained section of a bladder biopsy taken from a child who presented with hematuria. The patient spent a few months at a refugee camp by the Nile in Ethiopia before arriving in the USA.
Figure 1: H&E stained bipsy of the bladder

Click here to view



  Question Top


What is your diagnosis?


  Answer to Image quiz Top


The diagnosis is Schistosomiasis

[Figure 1] featured a section from a fibrotic area of the bladder wall infested with eggs of Schistosoma haematobium highlighted by the arrows in the demarcated image below [Figure 2]. This parasitic infection is endemic to the Nile Valley from Ethiopia and Sudan and Egypt. Ancient archival material proves the prevalence of this disease there since the dawn of recorded history. The earliest case of human Schistosomiasis diagnosis (confirmed by immunologic ELISA method) was found in the mummified body of an Egyptian adolescent dating back to more than 5,000 years ago[1]. In a study by Miller et al., 15 out of 23 mummies tested showed evidence of schistosomiasis[2]. Apparently, hematuria, likely due to schistosomiasis, was so prevalent in ancient Egypt that in a papyrus dated to the Pharaonic era, a palace physician expressed concern if an adolescent boy reaches puberty and reported no blood in his urine; similar to the concern encountered in females reaching adolescent age with no sign of blood or mensuration!
Figure 2: A representative section from bladder mucosa with arrows pointing to Schistosoma eggs in a fibrotic background. Note the terminal spine (arrowhead) that help separate Schistosoma Haematobium from S. Mansoni and S. Japonicum

Click here to view


Schistosomiasis (also known as Bilharzia) is one of the most prevalent parasitic diseases. Schistosoma haematobium is the prevalent species in Africa and the Nile valley. Schistosoma Mansoni is encountered – in addition to Africa- in South America, while Schistosoma Japonicum occurs in Japan, China and South East Asia. The eggs of these parasites are helpful in designating the species at the microscopic level. Schistosoma haematobium eggs are oval and show a terminal spike. Schistosoma Mansoni eggs are also oval but show a lateral spike. The eggs of Schistosoma Japonicum are smaller, round and show a very small lateral spike or no spike.

Author's contribution

None.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Compliance with ethical principles

Not required.



 
  References Top

1.
Deelder AM, Miller RL, de Jonge N, Krijger FW. Detection of schistosome antigen in mummies. Lancet 1990;335:724-5.  Back to cited text no. 1
    
2.
Miller RL, Armelagos GJ, Ikram S, De Jonge N, Krijger FW, Deelder AM. Palaeoepidemiology of Schistosoma infection in mummies. BMJ 1992;304:555-6.  Back to cited text no. 2
    


    Figures

  [Figure 1], [Figure 2]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Clinical Context
Question
Answer to Image quiz
References
Article Figures

 Article Access Statistics
    Viewed132    
    Printed0    
    Emailed0    
    PDF Downloaded20    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]