Profilaktik tibbiyot va salomatlik
–
Профилактическая
медицина
и
здоровье
–
Preventive Medicine
and Health
Journal home page:
https://inscience.uz/index.php/preventive-medicine
Morphological changes in liver echinococcosis in age
aspect
Islam MIRKHODJAYEV
Bukhara State Medical Institute
ARTICLE INFO
ABSTRACT
Article history:
Received April 2024
Received in revised form
10 May 2024
Accepted 25 May 2024
Available online
15 August 2024
A study of the intravital morphological structures of the liver
with varying sizes and localizations of hydatid cysts across
different age groups of patients revealed the following: liver
tissue in areas adjacent to the echinococcal cyst exhibits the
most pronounced changes. These changes are characterized by
a disruption of the hepatic beam structure and dystrophic
alterations in the hepatocytes. In more distant areas of the liver
parenchyma, slight dystrophic changes in hepatocytes are
observed in the presence of small and medium-sized
echinococcal cysts. However, with giant cysts, these changes
become more pronounced and diffuse, emphasizing the need for
meticulous preoperative preparation by the surgeon.
2181-3663
/©
2024 in Science LLC.
https://doi.org/10.47689/2181-3663-vol3-iss4-pp3
This is an open-access article under the Attribution 4.0 International
(CC BY 4.0) license (
https://creativecommons.org/licenses/by/4.0/deed.ru
Keywords:
liver echinococcus,
morphological studies of
parasitic cysts,
age groups.
Жигар эхинококкозида турли ёшдаги беморларда
морфологик ўзгаришлар
АННОТАЦИЯ
Калит сўзлар:
жигар эхинококки,
паразитар кисталарни
морфологик
текширишлар,
турли ёшдаги беморлар.
Хар хил ёшдаги беморлар гурухида жигарнинг турли
жойларида жойлашган, хар хил ўлчамли эхинококкида
паренхимасидаги морфологик тузилиши текширилганда
қуйидагилар аникланди: кистага яқин жойлашган жигар
паренхимаси устунларининг тузилишини ўзгарганлиги ва
шу соҳада гепатоцитларда дистрофик ўзгаришлар
аниқланди. Кичик ва ўрта ўлчамдаги кисталарда ундан
узоқда жигар паренхимасида гепатоцитларда бироз
дистрофик ўзгаришлар кузатилган бўлса, гигант ўлчамдаги
1
DSc, Professor, Bukhara State Medical Institute. Bukhara, Uzbekistan. E-mail: islom-abx@mail.ru
2
Assistant, Bukhara State Medical Institute. Bukhara, Uzbekistan. E-mail: dastanrajabov584@gmail.com
Profilaktik tibbiyot va salomlatlik
–
Профилактическая медицина и здоровье–
Preventive Medicine and Health
Issue
–
3
№
4 (2024) / ISSN 2181-3663
34
кисталарда шу соҳада ўзгаришлар бир мунча ифодаланган
ва
диффуз
ҳолатда
эканлигианиқланди.
Бундай
ўзгаришлар беморларни операцияга хирурглар томонидан
пухта тайёргарлик ўтказилишини талаб қилади.
Морфологические изменения при эхинококкозе
печени в возрастном аспекте
АННОТАЦИЯ
Ключевые слова:
эхинококк печени,
морфологические
исследования
паразитарных кист,
возрастные группы
.
Проведенное
исследование
прижизненных
морфологических структур печени при различных
размерах и локализации гидатидозных кист в разных
возрастных группах больных выявило следующее:
наиболее выраженным изменениям подвергается ткань
печени в зонах, находящихся в непосредственной близости
от эхинококковой кисты. Эти изменения проявляются
нарушением
балочного
строения
печени
и
дистрофическими
изменениями
гепатоцитов.
В отдаленных участках паренхимы печени при наличии
эхинококковых кист небольшого и среднего размера
выявляются незначительные дистрофические изменения
гепатоцитов. Однако при гигантских кистах эти изменения
становятся
более
выраженными
и
приобретают
диффузный характер, что требует от хирурга тщательной
предоперационной подготовки.
SUMMARY
INTRODUCTION
Echinococcosis is a parasitic disease with a wide geographical prevalence in the
world. The thickness of the echinococcal cyst may indicate the age of infection.
The research aims
to study the lifetime morphological changes of the liver with
different sizes and localization of gadatidous liver cysts in different age groups of
patients. Morphological examination was confirmed by pieces of tissue of the fibrous
capsule of the liver near parasitic cysts, as well as biopsies from remote areas of the liver.
MATERIALS AND METHODS
Surgical treatment was performed in 267 patients with single-chamber
echinococcosis of the liver. There were 31 (12%) patients under the age of 20, 138 (52%)
from 21 to 40, 77 (23%) from 41 to 60, and 21 (8%) patients over the age of 60.
Histological examination was performed in 49 patients, pieces of liver from the fibrous
capsule and adjacent liver tissue taken during surgery were fixed in a solution of
10% neutral formalin.
Histological sections were stained with hematoxylin
–
eosin according to
Van Gieson.
THE RESULTS OF THE RESEARCH AND DISCUSSION
Depending on the size of the cysts, 2 groups were conditionally distinguished: the
first group
–
small cysts
–
86 (22%) observations, the second group
–
large and giant
cysts
–
181 (68%) observations. It was noted that with increasing age of patients, the
Profilaktik tibbiyot va salomlatlik
–
Профилактическая медицина и здоровье–
Preventive Medicine and Health
Issue
–
3
№
4 (2024) / ISSN 2181-3663
35
number of cases of liver echinococcosis with large and giant cysts increases. Complicated
cysts in the form of suppuration were observed in 26 (13%) patients and were more
common in adults, especially in middle-aged and elderly patients with large and giant
cysts.
The formation of a parasitic cyst begins 4 days after fixation in tissues. The cyst
size by the end of the first month is 1 mm, after three months it is 2 mm, then there is a
sudden acceleration of growth, the average growth rate is 1-3 cm per year.
The fibrous capsule is the result of productive inflammation developing around a
growing parasitic cyst. The fibrous capsule can be divided into three layers. The outer
one is usually represented by a roughly fibrous connective tissue consisting of
longitudinally arranged bundles of collagen fibers and few fibroblasts. In the middle
layer, the collagen fibers are loosely arranged. Small blood vessels are detected between
them. Along with fibroblasts, lymphoid cells, eosinophils and single polymorphonuclear
leukocytes are located around the vessels.
Around small echinococcal cysts, unlike giant cysts, the fibrous capsule is usually
smaller due to less developed coarse-fibrous connective tissue. In complicated
echinococcosis with suppuration, the fibrotic capsule is usually thickened and
abundantly infiltrated by polymorphonuclear leukocytes.
The inner layer of the capsule adjacent to the liver parenchyma has no clear
boundaries and is represented by granulation tissue rich in blood vessels and here many
lymphocytes, fibroblasts and eosinophils are detected.
The structure of the liver in the transition zone is undergoing significant changes.
Hepatocytes are arranged randomly and quite densely. In this zone, atrophic processes in
the parenchyma are expressed to the maximum extent.
Protein-fat dystrophy of hepatocytes is more pronounced in the areas of the
parenchyma closest to echinococcus, necrobiosis and necrosis of individual hepatocytes
are not observed. In portal tracts with dilated full-blooded vessels, significant
inflammatory infiltration is observed, consisting of lymphocytes and eosinophils. Massive
inflammatory infiltration spreads to the walls of the bile ducts, mainly portal ducts.
Foci of stasis and bile clots are noted in the lobules.
Proliferation of stellate reticuloendotheliocytes is observed in the periportal zones.
With suppuration of echinococcus, microabsesses are found in nearby areas of the
liver. The study of the structure of the fibrous capsule around echinococcal cysts in
various age groups shows that in young and middle age it is significantly infiltrated by
inflammatory elements and fibroblasts. In the area adjacent to the parenchyma,
dystrophic and atrophic processes are poorly developed. In elderly and especially senile
patients with uncomplicated echinococcosis, the predominance of large and giant cysts,
and dystrophic and atrophic changes in hepatocytes were significantly pronounced. The
number of vessels in the fibrous capsule is much smaller, it mainly consists of atrophied
liver tissue and collagen fibers.
CONCLUSION
Thus, as morphological studies have shown, liver tissue is most susceptible to
changes in areas near the echinococcal cyst. This is manifested both by a violation of the
hepatic girder structure and by dystrophic changes in the hepatocytes themselves. In
remote areas of the liver parenchyma, minor dystrophic changes in hepatocytes are
detected in small and medium-sized echinococcal cysts, while in giant cysts these
changes are more pronounced and diffuse, which requires careful preoperative
preparation from the surgeon.
Profilaktik tibbiyot va salomlatlik
–
Профилактическая медицина и здоровье–
Preventive Medicine and Health
Issue
–
3
№
4 (2024) / ISSN 2181-3663
36
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