Pierre C, Civatte M, Chevalier A, Terrier J P, Gros P, Carloz E
Service d'Anatomie Pathologique, l'Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France.
Med Trop (Mars). 1998;58(1):85-97.
Most publications devoted to diagnosis of helminths emphasize characteristic parasitological features. Histological feature are seldom described in detail. The purpose of this study was to propose a diagnostic method suitable for use by histologists who, unlike parasitologists, do not visualize the whole worm but rather pieces randomly scattered over a slide. It is relatively easy to distinguish helminths which have smooth muscle, no respiratory or circulatory system, and no coelom from arthropods which have striated muscle, both respiratory and circulatory systems, and coelom. At the adult stage, roundworms or nemathelminths present an external cuticle that may have patterned markings. The visceral cavity is empty. Adults can dwell either in the intestine in which case they are oviparous (oxyuris, ascaris, Ancylostoma, Strongyloides stercoralis, Trichuris...) or in tissue in which case they are viviparous (filaria). Larva of some species can be found in tissues. Adult tape-worms are devoid of cuticle and have a mesenchymatous visceral cavity. Cestodes which are segmented and have no digestive tract (taenias) are readily distinguishable from trematodes which are not segmented and have a digestive tract (faciolasis) Some cestodes unable thrive in man can cause cyst formation (hydatidosis, sparganosis, cysticercosis, coenurosis). On the basis of symptoms and histological features, it is usually possible to diagnose the genus and even the species of the offending helminth provided that the parasite has not been excessively damaged and that a sufficient number of sections are available.
大多数关于蠕虫诊断的出版物都强调其特征性的寄生虫学特征。组织学特征很少被详细描述。本研究的目的是提出一种适合组织病理学家使用的诊断方法,与寄生虫学家不同,组织病理学家看不到完整的蠕虫,而是看到随机散布在载玻片上的碎片。将具有平滑肌、无呼吸或循环系统且无体腔的蠕虫与具有横纹肌、呼吸和循环系统以及体腔的节肢动物区分开来相对容易。在成虫阶段,蛔虫或线虫呈现出可能有图案标记的外部角质层。内脏腔是空的。成虫可栖息在肠道中,此时它们是卵生的(蛲虫、蛔虫、钩虫、粪类圆线虫、鞭虫……),或者栖息在组织中,此时它们是胎生的(丝虫)。某些物种的幼虫可在组织中发现。成年绦虫没有角质层,有间充质内脏腔。有节段且无消化道的绦虫(绦虫)很容易与无节段且有消化道的吸虫(肝片吸虫病)区分开来。一些不能在人体内茁壮成长的绦虫可导致囊肿形成(包虫病、裂头蚴病、囊尾蚴病、多头蚴病)。根据症状和组织学特征,通常可以诊断出致病蠕虫的属甚至种,前提是寄生虫没有受到过度损害且有足够数量的切片。