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96.3.-ECHINOCOCCOSIS IN FORENSIC PATHOLOGY IN SPAIN. PROF.GARFIA.A

96.3.-HYDATID CYSTS  IN SOUTHWEST OF SPAIN.  A FORENSIC POINT OF VIEW.  HISTOPATHOLOGICAL FINDINGS IN LUNGS AND LIVER.

Prof.Garfia.A

96.3-HIDATIDOSIS Patologia FORENSICS EN EN EL SURO DE ESPAÑA: HALLAZGOS Pulmonary Y HEPÁTICOS.

Prof.Garfia.A

96.3-hydatidosis IN FORENSIC PATHOLOGY IN SOUTHWEST SPAIN: PATHOLOGICAL FINDINGS IN LIVER AND LUNG.

Prof.Garfia.A

CASE NO 3

Case description

is an individual, a German national, who died in a tourist city on the Andalusian coast. The autopsy report gave a diagnosis of death from acute cardiorespiratory failure. Blood alcohol content was close to 3.0 g / L.

Histopathology

The liver showed numerous cysts, the largest of which measured about 5 mm in diameter, some of them were calcified and necrotic centers.

Microscopically, cysts were formed by a thick capsule of dense fibrous tissue, surrounding a cavity containing calcified debris and covered by a fabric composed of several cell layers within which were epithelioid-like cells and multinucleated giant cells (arrows). The cysts were found in different evolutionary stages towards the formation dense fibrotic nodules, and solid cystic cavity. None of the cysts examined was possible to display the membrane prolígera / germination, or the laminate layer, typical of hydatid cysts. It issued a diagnosis of liver cysts compatible with inactive hydatid cysts in the evolutionary process towards residual fibrosis. The remaining parenchyma showed steatosis, macrovesicular type, severe panlobular (+ 75% of hepatocytes affected), alcohol compatible.

Fig.1 .- Masson.Panorámica Hígado.Tricrómico of liver at low magnification. Inactive hydatid cysts. The composite photograph shows five cysts (three in the field below, one at 9 in the dial face, and another at 14 hours), which are at different evolutionary stages. Note that the cavity field below have a relatively large necrotic material occupied by calcium. The cyst located at 9 in the dial face, smaller size, has a coating endoquístico by a newly formed tissue containing epithelioid cells and multinucleated giant cells, foreign body replaces what would be the cystic lining or prolígera germination. Prof.Garfia.A

Fig.2 .- Detail inactive cyst, located at 9 in the dial face. Note the thick adventitial or pericyst, consisting of dense fibrous tissue oriented, the absence of laminated membrane, the membrane destruction germination or germ layer and its replacement by a multilayer cell containing fibroblasts, epithelioid cells and giant cells of Masson multinucleadas.Tricrómico. Prof. Garfia.A

         

Fig. 3.- Detail multilayer membrane replacement cell cystic germination, which has disappeared (inactive cyst). The arrow pointing to a giant cell multinucleada.Tricrómico Masson. Prof. Garfia.A

Fig. 4.- Detalle para mostrar la formación de células gigantes multinucleadas (flecha), en el seno la cavidad quística, encargadas de la fagocitosis de la membrana germinativa. Tricrómico de Masson.  Prof. Garfia.A

Fig.5. fibrotic cyst-Detail of Figure 1.
Prof.Garfia.A