Schistosoma Hematobium and Bladder Cancer..pptx

Medical School project about Schistozoma Haematobium and how it leads to Bladder Carcinoma

1. Schistosoma Hematobium and Cancer bladder

2. ILOS 1- Know the geographical distribution of Schistizoma Haematobium . 2- Study Morphology and Life cycle of Schistizoma Haematobium 3- Mechanism of How Schisrosoma Haematobium Causes Cancer Bladder 4- Know the preventine measures against Schistosoma Haematobium

3. Geographical Distribution It is found in : Egypt (Nile Valley ) Africa South America

4. Morphology Adult Male : Size : 12mm Shape : Lateral margins folded ventrally to form gynaecophoric canal Tegument : covered with fine tuberculated. Suckers : Oral sucker and ventral larger one Genital pore : Just posterior to the ventral sucker Alimentary canal: The two simple intestinal caeca unite into a single caecum in the posterior third of the body

5. Adult Female : Size : 20mm Shape : The body is cylindrical & longer than the male. Tegument : Ovary : Ovoid in the posterior third of the body in front of union of the intestinal caeca Smooth .

6. The Egg : Size : Shape : Color : Content : 140 x 60 mm Large terminal spine Translucent Miracidium

7. Miracidium Miracidium Miracidium Schistosomulum Cercaria Sporocyst Miracidium It is the migratory larval form within the definitive host. Morphologically it is a tall-less cercaria Purcocercus cercaria with penetration glands and bifid tail A sac-like stage containing germinal cells It is small, oval, elongated & ciliated Miracidium

8. Life Cycle

9. Life Cycle Habitat : Vesical and pelvic venous plexus Host : -D.H: Man -R.H: ……… -I.H: Bulinus trancatus Diagnostic Stage : Mature Eggs Infective Stage : Furcocercous Cercaria Mode of Infection : Skin penetration Life span : Up to 20 years

10. Clinical Manifestations Early Stages 1- Cercarial dermatitis : at the penetration site of Circariae leading to itching and papular eruptions 2- Schistosomular migration : Migration of Schistosomula causes - Pneumonitis - Tender Hepatomegaly 3- Acute Schistosomiasis ( Katayama Syndrome ): It occurs when warms mature in the liver , migrate to the small venules and begin to lay eggs . There is fever , abdominal pain, diarhea , wheezing , marked Eosinophilia , lymph node enlargment .

11. Clinical Manifestations Late Stages 1- Chronic Urinary Schistosomiasis : Ovaposition in the vesical plexus leading to terminal hematuria, dysuria frequency Advanced 1- Obstruction of the urinary tract 2- Urinary Stones 3- Recurrent bacterial urinary infections 4- Egg Embolism 5- Bladder Cancer 6- Chronic Microcytic hypochromic Anemia

12. Mechanism of How Schistosoma Haematobium After penetration of skin or mucous membranes, schistosomulae migrate through the lungs to portal venous system and mature into adults About 6 weeks later, adult worms migrate to bladder venules Females lay eggs that reach the bladder wall, penetrate bladder mucosa and excrete into urine Bladder wall shows eggs and mixed inflammatory reaction with lymphocytic, neutrophilic and eosinophilic infiltrate and scarring of the vesicular vessels Bladder wall shows eggs and mixed inflammatory reaction with lymphocytic, neutrophilic and eosinophilic infiltrate and scarring of the vesicular vessels Eggs may block drainage of urine into the bladder, causing hydroureter and may develop secondary bacterial urinary tract infections, renal failure and pulmonary hypertension It may progress to Squamous cell metaplasia and dysplasia then squamous cell carcinoma

13. Eggs of  S. haematobium  surrounded by intense infiltrates of eosinophils in bladder tissue

14. Histological image showing a well differentiated and keratinized squamous cell carcinoma associated A, with Schistosoma haematobium calcified eggs with their characteristic terminal spine B (hematoxylin and eosin stain × 100)

15. Macroscopic resected specimens (after formalin fixation and inking) showing the partial cystectomy largely occupied by an ill-defined infiltrative whitish tumor, with 2 epiploic fragments invaded by tumoral nodules (arrows)

16. Diagnosis 1-The gold standard for the evaluation of the lower urinary tract is a routine outpatient procedure called a cystoscopy . 2-The most efficient, noninvasive and inexpensive test is a urinalysis/cytology. 3- ultrasound 4-biopsy 5-MIR /CT ( for sings of metastasis )

17. Treatment 1-Surgery. Surgery is the main treatment for bladder cancer. 2-Radiation therapy. Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. 3-Chemotherapy. 4-Immunotherapy. 5-Follow-up testing.

18. Prevention & Control Sanitation Avoiding bathing or swimming in snail-infested waters Proper sewage Disposal Public health education Explanation of the life cycle, the mode of infection and hazards of the disease in a simple way to the population. This done in schools, mosques, churches, press, cinema and TV. Vaccine Development Offers promising Control of this important health problem

19. Snail Eradication Clearance of canals from weeds and vegetations Drying of canals. Construction of canals using concrete. Putting palm leave-traps to collect and destroy snails. 2- Biological C ontrol : Plantation of special trees toxic to snails as Balanites aegyptiaca. Using natural enemies as ducks, geese and mollusc-eating fish such as Tilapia & Gambusia Using competitor snails as Marisa and Helisoma 3- C hemical C ontrol (molluscicides) : Copper sulphate (5 p.p.m.) is effective against adult snails only Bayluscide (dichloro-nitrosalicylicanilid) 0.5 p.p.m., kills both adult snails & their eggs 1- Environmental Control :

20. Snail Eradication Clearance of canals from weeds and vegetations Drying of canals. Construction of canals using concrete. Putting palm leave-traps to collect and destroy snails. 2- Biological C ontrol : Plantation of special trees toxic to snails as Balanites aegyptiaca. Using natural enemies as ducks, geese and mollusc-eating fish such as Tilapia & Gambusia Using competitor snails as Marisa and Helisoma 3- C hemical C ontrol (molluscicides) : Copper sulphate (5 p.p.m.) is effective against adult snails only Bayluscide (dichloro-nitrosalicylicanilid) 0.5 p.p.m., kills both adult snails & their eggs 1- Environmental Control :

21. References Urogenital schistosomiasis—history, pathogenesis, and bladder cancer :Lúcio L Santos, J, Maria J .Journal of Clinical Medicine 10 (2), 205, 2021 Understanding urogenital schistosomiasis-related bladder cancer: an update ,K Ishida, H Hsieh.Frontiers in medicine 5, 223, 2018 Schistosomiasis and urinary bladder cancer in North Western Tanzania: a retrospective review of 185 patients ,P Rambau, P Chalya, K Jackson. Infectious agents and cancer 8, 1-6, 2013

22. Thank You