“Flask shaped” ulcers in intestine are seen in:
Correct Answer: Amoebic infection
Description: Ans. c (Amoebic infection). (Ref. Harrison's, Principle of Medicine, 18th /Chapter 209. Amebiasis)PATHOGENESIS AND PATHOLOGY OF INTESTINAL AMOEBIASIS:# Both trophozoites and cysts are found in the intestinal lumen, but only trophozoites of E. histolytica invade tissue.# The trophozoite is 20-60 pm in diameter and contains vacuoles and a nucleus with a characteristic central nucleolus.# Trophozoites attach to colonic mucus and epithelial cells by Gal/GalNAc.# The earliest intestinal lesions are microulcerations of the mucosa of the cecum, sigmoid colon, or rectum that release erythrocytes, inflammatory cells, and epithelial cells.# Submucosal extension of ulcerations under viable-appearing surface mucosa causes the classic "flask-shaped" ulcer containing trophozoites at the margins of dead and viable tissues.# Treated ulcers characteristically heal with little or no scarring.# Occasionally, however, full-thickness necrosis and perforation occur.# Rarely, intestinal infection results in the formation of a mass lesion, or ameboma, in the bowel lumen.# Liver abscesses are always preceded by intestinal colonization, which may be asymptomatic.# Blood vessels may be compromised early by wall lysis and thrombus formation.# Trophozoites invade veins to reach the liver through the portal venous system.# E. histolytica is resistant to complement-mediated lysis--a property critical to survival in the bloodstream.# In contrast, E. dispar is rapidly lysed by complement and is thus restricted to the bowel lumen.# The necrotic contents of a liver abscess are classically described as "anchovy paste," although the fluid is variable in color and is composed of bacteriologically sterile granular debris with few or no cells. Amebas, if seen, tend to be found near the capsule of the abscess.
Category:
Pathology
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