Case 57.  Clonorchiasis (75 y-o F)
         
   
Bile from a farm housewife, complaining of abdominal pain and mild jaundice
   
         
   
Key words :  Clonorchis sinensis, cholangitis
   
     
 
     
Echography of the gallbladder demonstrates parasites deposited in the gallbladder. No acustic shadow is seen.   Numerous gold-colored small ova are seen in the bile (unstained preparation). Note their small size (30 μm) and the operculum.
     
 
     
Histologic features of the fluke, removed by surgery. Ova-containing uterus surrounds the ventral sucker. No spicules are seen in the cuticle (Compare with Fasciola hepatica shown in the reference case 51B).   Reference case 57A
Surgically resected liver abscess containing numerous small-sized ova (66 y-o female, HE). The small size of the ova strongly suggests clonorchiasis, but the microscopic obsrevation of the ova in the bile or stool and/or serological testing are requested for the definite diagnosis.