Proliferation and metastases formation of larval Echinococcus multilocularis. I. Animal model, macroscopical and histological findings.

Using surgical techniques, 70 Meriones unguiculatus were infected by implantation of 0.15-0.20 g of larval Echinococcus multilocularis tissue into the subcutis of the neck region. In 64 of 65 animals necropsied, the transplants had increased in size and weight and reached an average weight of 4.1 g at the end of the experiment 12 weeks post infection (p.i.). Metastatic Echinococcus lesions developed in the regional lymph nodes and in the lungs; in 18 animals the parasite proliferated into the thoracic cavity. Of 41 animals examined 10 and 12 weeks p.i., 88% had multiple or single metastatic lung lesions, the first being observed 6 weeks p.i. Typical cysts and protrusions ("buds") of the germinal layer were detected in samples of parasite tissue before and after transplantation to experimental animals, as well as in lymph nodes and lungs in which metastases had developed. Similar structures were found in liver sections of two patients with alveolar echinococcosis. It is concluded that the spread of the parasite from the subcutis of the neck region to the draining lymph nodes and the lungs had taken place via the lymph and blood system. The possible role of the "buds" in metastases formation is discussed.