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File:IPLab11Schistosomiasis3.jpg|This is a photomicrograph of the liver from another patient with Schistosoma mansoni. These eggs have elicited a robust inflammatory response, including a multinucleated giant cell. These lesions go on to heal by fibrosis resulting in cirrhosis and the classic "pipe-stem" fibrosis.
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== Study Questions ==
* <spoiler text="How did the patient acquire schistosomiasis?">Fresh water snails are required intermediate hosts for schistosomal organisms. The snails release cercaria into the water that can penetrate the skin of anyone walking in the water. Since this patient worked on a fish farm, he spent a lot of time in the water.</spoiler>
* <spoiler text="How do Schistosoma mansoni eggs cause liver pathology?">A substance released from the eggs is a direct hepatotoxin. The eggs incite a chronic granulomatous inflammatory reaction (thought to be mediated by TNFa and T-helper cells). And schistosome eggs stimulate lymphocytes to secrete lymphokines that stimulate periportal fibrosis.</spoiler>
* <spoiler text="How does the clinical picture of S. haematobium differ from that of the other schistosomes?">S. haematobium leads to granulomatous lesions in the urinary bladder that can erode the surface epithelium and lead to hematuria. Chronic inflammation and fibrosis can lead to obstruction, hydronephrosis and ascending bacterial infections. There is also an increased risk for squamous cell carcinoma of the bladder.</spoiler>
{{IPLab 11}}
[[Category: IPLab:Lab 11]]
