title: Dicrocoelium Dentriticum in Explanted Liver: Report of an Unusual Finding.
abstract: Dicrocoelium dentriticum, a member of trematode type helminths, is a liver parasite of ruminants. Humans are infected accidentally by ingestion of intermediate host, through infected ants via eating of raw vegetables or drinking of contaminated water. Infection is often asymptomatic or results in subtle symptoms; therefore, infections are usually unrecognized. However, it can produce chronic cholangitis and swelling or adenomatous proliferation in the bile ducts and lead to abdominal pain, diarrhea, fatigue, jaundice, and other symptoms. We report a 49-year-old female patient with end-stage hepatic cirrhosis from viral hepatitis B and D coinfection who underwent liver transplant. Shortly after transplant, she developed symptoms suggesting an obstructed biliary duct. Liver needle biopsy was done 24 hours after transplant to rule out rejection. Biopsy of her explanted liver was also examined pathologically. Microscopic examination of the liver needle biopsy ruled out rejection. Prepared sections of explanted liver revealed a helminth in the common bile duct. Morphologic reconstruction of helminth by microscopic findings and consultation with an expert parasitologist supported the diagnosis of Dicrocoelium dentriticum.
authors.affiliation: Pathology Department, Cancer Research Institute, Liver Transplant Research Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Farid
authors.initials: F
authors.lastname: Azmoudeh-Ardalan
authors.forename: Vahid
authors.initials: V
authors.lastname: Soleimani
authors.forename: Behnaz
authors.initials: B
authors.lastname: Jahanbin
mesh_terms: D000818:Animals; D000980:Antiplatyhelmintic Agents / Q000627:therapeutic use; D001706:Biopsy; D004011:Dicrocoeliasis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D004013:Dicrocoelium / Q000187:drug effects / Q000302:isolation & purification*; D058625:End Stage Liver Disease / Q000175:diagnosis / Q000469:parasitology / Q000601:surgery* / Q000821:virology; D005260:Female; D006498:Hepatectomy; D006801:Humans; D016031:Liver Transplantation; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000980:Antiplatyhelmintic Agents