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A patient who underwent mastectomy of the left breast owing to breast Turkish mature cigdem was referred to our department for abdominal ultrasonography during her routine check-up. Radiological examinations demonstrated multiple masses that tended to form clusters in the liver parenchyma, and the lesions were initially thought to represent metastases Turkish mature cigdem the breast cancer.

Multisite biopsies and serological tests confirmed the diagnosis of Fasciola hepatica infestation. To our knowledge, this is a unique case report of a patient with a known malignant neoplasm. We also present an overview of the literature about human fascioliasis in Turkey. Owing to their long historical background, environmental Turkish mature cigdem climatic features, biodiversity and proximity of the people to animals some zoonotic diseases are seen more frequently in the countries of the Mediterranean and the Middle East.

Introduction

Its human infestation can be seen in Anatolia the western peninsula of Asia that forms the mainland of Turkey. As its radiological findings may mimic metastases, it is important to consider F. We herein present the case of a year-old female patient with a history of breast cancer who had presented with multiple liver lesions that were finally proven Turkish mature cigdem be consistent with fascioliasis. Turkish mature cigdem year-old female who had undergone right mastectomy for breast carcinoma was referred to our department for evaluation of the multiple liver masses detected on routine follow-up examinations.

Sonographic examination of the patient revealed hepatosplenomegaly and multiple heterogeneous hypoechoic Turkish mature cigdem of varying sizes that were located centrally in the right lobe of the liver and tended to form clusters. Some of the larger lesions had central necrosis and cavitation areas Figure 1. We observed hypoechoic curvilinear tracts Turkish mature cigdem from the liver capsule to the parenchyma, which did not demonstrate abnormal vascularity on colour Doppler ultrasound examination Figure 2.

The gallbladder had normal wall Turkish mature cigdem and endoluminal echogenicity. Note the central necrosis area in one of the larger-sized lesions large arrow. Ultrasound-guided fine needle Turkish mature cigdem of the selected lesions were performed.

Pathological examination of the specimens showed no evidence of Turkish mature cigdem but eosinophil-rich inflammatory necrotic tissue was reported. Blood tests also revealed elevated levels of eosinophils and serological tests confirmed the presence of F. The patient was discharged after a course of triclabendazole treatment. Fascioliasis is included in the group of food Turkish mature cigdem snail -borne trematodiases and is caused by two species of parasitic flatworms: Although the natural final hosts of this parasite are sheep, goats, cattles and other herbivores, F.

Despite the belief that it has a European origin, F. The parasite can easily adapt and colonize in rural areas and wetlands, where there are plenty of freshwater Lymnaea snails the intermediate hosts and herbivorous mammals the definitive hosts.

If it is detected in some livestock animals, human cases may also exist. The eggs of the parasite are excreted with the final host's faeces. These eggs are immersed in freshwater, and the swimming, ciliated miracidia forms are released. Cercariae use the aquatic plants watercress, watermint, lettuce, spinach orother salad vegetables as another group of intermediate hosts; the cercarial Turkish mature cigdem encyst and develop into the metacercarial stage.

The main transmission of F. Human infestation by this trematode has two characteristic phases: The first phase is the hepatic phase. The clinical features of this stage include anorexia, fatigue, nausea, vomiting, right upper quadrant pain, pruritus, fever, weight Turkish mature cigdem, respiratory symptoms, hepatomegaly, jaundice and urticaria.

Laboratory findings such as elevated liver enzymes, increased erythrocyte sedimentation rate, hypergammaglobulinaemia and marked eosinophilia can be encountered in this stage as well. Mild hepatitis, severe hepatic subcapsular haemorrhage or liver necrosis may also be seen rarely in this hepatic phase.

The second stage may be asymptomatic for a long time or may be characterized by intermittent right upper quadrant pain. When the flukes follow the migration path from the liver capsule to the bile ducts, they ingest hepatocytes.

Along Turkish mature cigdem migration path, multiple small necrotic cavities and microabscesses arise. These abscess cavities are not large, as seen in the cases of other suppurative processes. On CT imaging, migration paths that extend from the Glisson's capsule to deep parenchymal areas tunnel-like tracts can be seen.

Also, serpentine, clustered, small necrotic cavities can be detected. Ultrasound examination may demonstrate single or multiple, elongated filamentous structures or moving echogenic flukes.

There are Turkish mature cigdem some reports that stress the importance of Turkish mature cigdem retrograde cholangiopancreatography ERCP in the diagnosis and treatment of the chronic phase of the disease. Ultrasound image reveals a thin, linear echogenicity, which is fixed at one end to the posterior wall of the Turkish mature cigdem bile duct.

Periportal lymphadenopathies may be accompanied by other radiological findings, as in our case.

The patient was asymptomatic and only choledochal dilatation was found incidentally during abdominal ultrasound examination; without any other suspicious imaging findings of metastasis. HF is a re-emerging disease Turkish mature cigdem common in some provinces of Turkey 29 Table 1. There are many published reports of human Turkish mature cigdem infections coming from these regions Table 2and also there are some case reports related to European travellers.

The published case series from the same centres may overlap.

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The disease continues to attract a large number of physicians who are studying in different departments in Turkey. Hepatobiliary fascioliasis should be kept in mind in the differential diagnosis of Turkish mature cigdem hepatic masses when suggestive clinical and laboratory findings are present, especially when the patients come from the endemic regions.

Knowledge of the radiological imaging characteristics of HF can aid in the diagnosis, and imaging is also useful in the evaluation of the treatment response. Written informed consent was obtained from the patient for publication of this case report, including Turkish mature cigdem images. National Center for Biotechnology InformationU. Published online May 8. Author information Article notes Copyright and License information Disclaimer. Published by the British Institute of Radiology.

Turkish mature cigdem is an open access article under the terms of the Creative Commons Attribution 4. Abstract A patient who underwent mastectomy of the left breast owing to breast cancer was referred to our department for abdominal ultrasonography during her routine check-up.

Summary Owing to their long historical background, environmental and climatic features, biodiversity and proximity of the people to animals some zoonotic diseases are seen more frequently in the countries of the Mediterranean and the Middle East.

Case Report A year-old female who had undergone right mastectomy for breast carcinoma was referred to our department for evaluation of the multiple liver masses detected on routine follow-up examinations.

Open in a separate window. Discussion Fascioliasis is included in the group of food or snail -borne trematodiases and is caused by two species of parasitic flatworms: Lifecycle of parasites The eggs of the parasite are excreted with the final host's faeces. Radiological findings When the flukes follow the Turkish mature cigdem path from the liver capsule to the bile ducts, they ingest Turkish mature cigdem. Conclusions Hepatobiliary fascioliasis should be kept in mind in the differential diagnosis of multiple hepatic masses when suggestive clinical and laboratory findings are present, especially when the patients come from the endemic regions.

Consent Written informed consent was obtained from the patient for publication of this case report, including accompanying images. Zoonoses in the Mediterranean region. Fascioliasis and other plant-borne trematode zoonoses. Int J Turkish mature cigdem ; Epidemiology of human fascioliasis: Bull World Health Organ ; Epidemiology of fascioliasis in human Turkish mature cigdem areas.

J Helminthol ; Diagnosis and treatment Turkish mature cigdem human fascioliasis: Res Rev Parasitol ; WHO Foodborne trematode infections. Fasciola Turkish mature cigdem infection in the United States. Arch Pathol Lab Med ; J Clin Imaging Sci ; 2: Keiser J, Utzinger J. Clin Microbiol Rev ; Biliary parasitic diseases including clonorchiasis, opisthorchiasis and fascioliasis.

Abdom Imaging ; Dig Surg ; Global burden of human food-borne trematodiasis: Lancet Infect Dis ; J Egypt Soc Parasitol ; Turkish mature cigdem J Clin Ultrasound ; Clinical presentation and management of fasciola hepatica infection: World J Gastroenterol ; Radiological findings in hepatobiliary fascioliasis. Turkiye Klinikleri J Med Sci ; A case of fasciola hepatica infection mimicking cholangiocarcinoma and ITS-1 sequencing of the worm.

Kisaengchunghak Chapchi ; An incidental case of biliary fascioliasis mimicking cholangiocellular carcinoma. Infez Med ; Fasciola hepatica mimicking malignancy of the liver and Turkish mature cigdem J Turgut Ozal Med Cent ; A case of fascioliasis mimicking sphincter of oddi tumor. Endoskopi Dergisi ; turkish turk webcams cigdem free. Turkish Turbanli WebCam. 41 sec Laila Nice Ass - k turk am evli KADININ AMI tas gibi turkish turk amator.

Cigdem Tokyol, Adem Aslan,1 Güler Senyildiz Hastürk,2 Emre Kacar,3 Turkish mature cigdem Mehmet Gazi Boyaci1 2Department of Pathology, Aksaray Public Hospital, Aksaray, Turkey. [12] Histopathologically they are composed of mature fibroadipose tissue. Microscopically the tumor is composed of alternating streaks of mature.

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The Journal of Infection in Developing Countries ; 8: Because the constituent tissues are normal components of the epineurium, some have considered this lesion to be a hamartoma of the nerve sheath. Fasciola hepatica in a New Zealander traveler. Cercariae use the aquatic plants watercress, watermint, lettuce, spinach orother salad vegetables as another group of intermediate hosts; the cercarial larvae encyst and develop into the metacercarial stage.

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