A 45-year-old man from Egypt presents with hematemesis and melena. Endoscopy reveals esophageal varices. Liver biopsy shows fibrosis around portal tracts with clay-stem fibrosis (Symmers pipestem fibrosis). Which organism is responsible for this pathological finding?
- A Schistosoma mansoni ✓
- B Schistosoma haematobium
- C Schistosoma japonicum
- D Clonorchis sinensis
Correct answer: A. Schistosoma mansoni
Explanation
Schistosoma mansoni eggs lodge in the portal venules, inducing a granulomatous reaction that leads to pre-sinusoidal portal hypertension and Symmers pipestem fibrosis. S. haematobium primarily affects the bladder causing hematuria. S. japonicum also causes portal hypertension but is prevalent in Asia. Clonorchis causes biliary fibrosis, not pipestem fibrosis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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