Table 36.8. Pathologic stages of Escobar correlated with radiographic findings and indications for treatment.
Escobar stage Pathology
Colloidal stage of the vesicular form
Earliest stage. Larva alive, invaginated, cyst fluid translucent
Parasite dying; degenerative changes present; cyst fluid jelly-like and white Cyst smaller; cyst fluid coarse granules
Complete mineralization of cyst fluid
No contrast enhancement or, rarely, homogeneous contrast enha ncement
Cystic lesions without contrast enhancement
Cyst isodense or hyperdense to brain, ring-enhancement present; may have edema around cyst
Increased signal on T2-weighted images; may see small nodule of gadolinium enhancement, or cyst with CSF-density fluid within Cystic lesion with thick capsule; on Tl-weighted images, fluid signal higher than CSF
Cystic lesion; fluid isodense to brain. Ring-enhancement with gadolinium
Patient asymptomatic; treatment with anthelmintic effective
Patient usually asymptomatic; treatment with anthelmintic effective
Patient symptomatic; treatment with anthelmintic probably not necessary; treat seizures with anticonvulsant
Patient symptomatic; treatment with anthelmintic not indicated; treat seizures with anticonvulsant
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