Three-Dimensional Reconstruction of Echinococcus multilocularis Larval Growth in Human Hepatic Tissue Reveals Complex Growth Patterns

Dennis Tappe Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany; Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Infectious Diseases Center, Division of Infectious Diseases and Clinical Immunology, University Hospital and Medical Center Ulm, Ulm, Germany; Institute of Pathology, University Hospital and Medical Center Ulm, Ulm, Germany

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Stephan Zidowitz Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany; Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Infectious Diseases Center, Division of Infectious Diseases and Clinical Immunology, University Hospital and Medical Center Ulm, Ulm, Germany; Institute of Pathology, University Hospital and Medical Center Ulm, Ulm, Germany

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Philipp Demmer Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany; Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Infectious Diseases Center, Division of Infectious Diseases and Clinical Immunology, University Hospital and Medical Center Ulm, Ulm, Germany; Institute of Pathology, University Hospital and Medical Center Ulm, Ulm, Germany

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Peter Kern Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany; Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Infectious Diseases Center, Division of Infectious Diseases and Clinical Immunology, University Hospital and Medical Center Ulm, Ulm, Germany; Institute of Pathology, University Hospital and Medical Center Ulm, Ulm, Germany

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Thomas F. E. Barth Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany; Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Infectious Diseases Center, Division of Infectious Diseases and Clinical Immunology, University Hospital and Medical Center Ulm, Ulm, Germany; Institute of Pathology, University Hospital and Medical Center Ulm, Ulm, Germany

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Matthias Frosch Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany; Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany; Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Infectious Diseases Center, Division of Infectious Diseases and Clinical Immunology, University Hospital and Medical Center Ulm, Ulm, Germany; Institute of Pathology, University Hospital and Medical Center Ulm, Ulm, Germany

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In this study we present, for the first time, a three-dimensional digital reconstruction of Echinococcus multilocularis larval growth in human tissue. Formalin-fixed, paraffin-embedded hepatic tissues from patients with alveolar echinococcosis were serially sectioned, stained, and areas of larval growth of the parasite were microphotographed. Parasitic structures were reconstructed from multiple digital planes, revealing a root-like network of interconnected vesicles and tubules extending into the periphery of lesions.

Author Notes

*Address correspondence to Dennis Tappe, Institute of Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Street 2, 97080 Würzburg, Germany. E-mail: dtappe@hygiene.uni-wuerzburg.de

Authors' addresses: Dennis Tappe and Matthias Frosch, Institute of Hygiene and Microbiology, University of Würzburg, Würzburg, Germany, E-mails: dtappe@hygiene.uni-wuerzburg.de and mfrosch@hygiene.uni-wuerzburg.de. Stephan Zidowitz, Fraunhofer MEVIS Institute for Medical Image Computing, Bremen, Germany, E-mail: stephan.zidowitz@mevis.fraunhofer.de. Philipp Demmer, Institute of Pathology, University of Würzburg, Würzburg, Germany, E-mail: phdemmer@gmx.de. Peter Kern, Comprehensive Infectious Diseases Center, Division of Infectious Diseases and Clinical Immunology, University Hospital and Medical Center Ulm, Ulm, Germany, E-mail: peter.kern@uniklinik-ulm.de. Thomas F. E. Barth, Institute of Pathology, University Hospital and Medical Center Ulm, Ulm, Germany, E-mail: thomas.barth@uniklinik-ulm.de.

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