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Histology Technician Field description Histology is an essential component to the art and science of pathology.

The histology laboratory contributes a valuable service to help pathologists provide patient diagnoses. Information gained through microscopic evaluation of tissue slides prepared by histology technicians allows a pathologist to either identify or dismiss disease. The preparatory steps taken to ensure a quality diagnosis are key to this relationship. Knowledge of the basic pathologic conditions, skills in the use of precision equipment, and performance of special stains enable histology technicians to accurately demonstrate the morphology of tissue specimens. Knowledge of biology, chemistry, anatomy, physiology and medical terminology is essential for the professional histology technician or technologist. In addition, attention to detail, good manual dexterity, and above all, a concern for patient well-being are imperative characteristics of a good histology technician. Endoparasites Protozoan organisms

Source/ Common name of organism or disease Latin name (sorted) Body parts affected Diagnostic specimen Prevalence Transmission (Reservoir/ Vector)

contact Acanthamoeba Acanthamoeba eye, brain culture worldwide lenses cleaned with tap water

Babesia B. divergens, B. Babesiosis bigemina,B. equi, B. microfti, B. duncani red blood cells Giemsa-stained New York, Martha's Vineyard, thin blood smear Nantucket (different species have worldwide distribution) tick bites, e.g. Ixodes scapularis

stool (diarrhea=ciliat intestinalmucosa, may Balantidiasis Balantidium coli become invasive in some patients ed trophozoite; solid stool=large cyst with horseshoe shaped nucleus) ingestion of cyst, zoonotic infection acquired from pigs (feces)




direct microscopy of stool (PCR, anti

eating food 2 - 20% of population [1] contaminated with feces from an infected human or

Source/ Common name of organism or disease Latin name (sorted) Body parts affected Diagnostic specimen Prevalence Transmission (Reservoir/ Vector)



ingestion of oocyst (sporulated), some Coccidia, cryptosporidiosis Cryptosporidium intestines stool widespread species are zoonotic (e.g. bovine fecal contamination)


Dientamoeba fragilis



up to 10% in industrialized countries

ingesting water or food contaminated with feces

stool (fresh Amoebiasis Entamoeba histolytica Intestines (mainly Large, can go to extraintestinal sites) diarrheic stools areas with poor sanitation, have amoeba, solid stool has cyst) high population density and tropical regions fecal-oral transmission of cyst, not amoeba

ingestion of cysts in Giardiasis Giardia lamblia lumen of thesmall intestine fecal contaminated stool widespread water or food, can be zoonotic (deer, beavers)


Isospora belli

epithelial cells ofsmall intestines

worldwide - less common stool dium

fecal oral route sporulated oocyst

thanToxoplasma or Cryptospori ingestion of

visual Leishmaniasis Leishmania cutaneous,mucocutane ous, or visceral identification of lesion or microscopic stain with Leishman's or

Visceral leishmaniasisWorldwide; Cutaneous leishmaniasis - Old World;Mucocutaneous leishmaniasis - New World

Phlebotomus Lutzom yia- bite of several species of phlebotomine sandflies

Source/ Common name of organism or disease Latin name (sorted) Body parts affected Diagnostic specimen Prevalence Transmission (Reservoir/ Vector)

Giemsa's stain

Nasal insufflation of Primary amoebic meningoencephalitis(PAM) Naegleria fowleri


contaminated warm brain culture rare but deadly fresh water, poorly chlorinated swimmin g pools, hot springs, soil

Plasmodium falciparum (80% of cases), Plasmodium Malaria vivax,Plasmodium ovale, Plasmodium malariae, Plasmodi um knowlesi red blood cells, liver Blood film tropical - 250 million cases/year Anopheles mosquito, bites at night

nasal mucosa came Rhinosporidiosis Rhinosporidium seeberi nose,nasopharynx reservoir water and soil into contact with India and Sri Lanka infected material through bathing in common ponds

ingestion of uncooked/undercook ed pork/lamb/goat with Toxoplasma bradyzoi tes, ingestion of raw Toxoplasmosis -Parasitic pneumonia Toxoplasma gondii eyes, brain, heart, liver blood and PCR widespread - up to one third of milk with all humans Toxoplasmatachyzoit es, ingestion of contaminated water food or soil withoocysts in cat feces that is more than one day old

Source/ Common name of organism or disease Latin name (sorted) Body parts affected Diagnostic specimen Prevalence Transmission (Reservoir/ Vector)


Trichomonas vaginalis

female urogenital tract (males asymptomatic)

microscopic examination of 7.4 million Americans genital swab

sexually transmitted infection - only trophozoite form (no cyst)

microscopic examination Sleeping sickness Trypanosoma brucei blood lymph and central nervous systems of chancre fluid , lymph node aspirates, blood, bone marrow 50,000 to 70,000 people tsetse fly, day biting fly of the genus Glossina

colon, esophagus, Chagas disease Trypanosoma cruzi heart, nerves, muscle and blood Helminths organisms (worms)

Giemsa stain blood

Mexico, Central America, South America - 16-18 million

Triatoma/Reduviidae - "Kissing bug" Insect Vector, feeds at night

Common name of organism or disease

Body Latin name (sorted) parts affected Diagnostic specimen Prevalence Transmission/Vector

Ancylostoma Ancylostomiasis/Hookworm duodenale, Necator americanus

lungs, small intestine, blood stool

common in tropical, warm, moist climates

penetration of skin by L3 larva

Anisakiasis [4]


allergic reaction


incidental host

ingestion of raw fish, squid, cuttlefish, octopus

Intestines, Roundworm - Parasitic pneumonia Ascaris sp. Ascaris lumbricoides liver, appendix, pancreas, lungs, Lffler's stool

common in tropical and subtropical regions

Common name of organism or disease

Body Latin name (sorted) parts affected Diagnostic specimen Prevalence Transmission/Vector


Roundworm Baylisascariasis

Intestines, Baylisascaris procyonis liver, lungs, brain

rare: North America

stool from raccoons

Roundworm-lymphatic filariasis

Brugia malayi, Brugia timori

lymph nodes

blood samples

tropical regions of Asia


Tapeworm - Tapeworm infection





Clonorchis Clonorchiasis sinensis; Clonorchis viverrini

Lancet liver fluke

Dicrocoelium dendriticum

gall bladder


ingestion of ants

Dioctophyme renalis infection

kidneys Dioctophyme renale (typically the right) Urine Rare

Ingestion of undercooked or raw freshwater fish

Diphyllobothriasis tapeworm

Diphyllobothrium latum

intestines, blood

Europe, Japan, stool (microscope) Uganda, Peru, Chile

ingestion of raw fresh water fish

Guinea worm Dracunculiasis

subcutaneous Dracunculus medinensis tissues, muscle skin blister/ulcer

South Sudan (eradication ongoing)

Common name of organism or disease

Body Latin name (sorted) parts affected Diagnostic specimen Prevalence Transmission/Vector

as intermediate host, Echinococcus Echinococcosis - tapeworm granulosus, Echinococc us multilocularis, E. vogeli, E. oligarthrus liver, lungs, imaging ofhydatid cysts in the Mediterranean countries kidney, spleen liver, lungs, kidney and spleen ingestion of material contaminated by feces from a carnivore; asdefinite host, ingestion of uncooked meat (offal) from a herbivore

Echinostoma echinatum small intestine

Far East

ingestion of raw fish, mollusks, snails

Enterobius Pinworm - Enterobiasis vermicularis, Enterobius gregorii

intestines, anus

widespread; stool; tape test around anus temperate regions

Fasciola hepatica in Europe, Africa, Australia, the Fasciola Liver fluke - Fasciolosis [5] hepatica, Fasciola gigantica Americas and liver, gall bladder stool Oceania; Fascio la gigantica only in Africa and Asia, 2.4 million people infected by both species freshwater snails

ingestion of infested Fasciolopsiasis - intestinal fluke [6] Fasciolopsis buski intestines stool or vomitus (microscope) East Asia - 10 million people water plants or water (intermediate host:amphibic snails)

Gnathostoma Gnathostomiasis

subcutaneous tissues (under physical examination the skin)

spinigerum, Gnathosto ma hispidum

rare - Southeast Asia

ingestion of raw or undercooked meat (e.g., freshwater fish, chicken, snails, frogs, pigs) or

Common name of organism or disease

Body Latin name (sorted) parts affected Diagnostic specimen Prevalence Transmission/Vector

contaminated water

Hymenolepis Hymenolepiasis

ingestion of material contaminated by flour beetles, meal worms, cockroaches

nana, Hymenolepis diminuta

Loa loa filariasis, Calabar swellings

Connective Loa loa filaria tissue, lungs, eye

blood (Giemsa,haematoxylin,eosin st ain)

rain forest of West Africa 12-13 million people Tabanidae - horse fly, bites in the day

Mansonelliasis, Filariasis

Mansonella streptocerca

subcutaneous layer of skin


Siberia, Metagonimiasis - intestinal fluke Metagonimus yokogawai stool Manchuria, Balkan states, Israel, Spain

ingestion of undercooked or salted fish

Africa, Yemen, Onchocerca River blindness volvulus, Onchocerciasi s skin, eye, tissue Central and bloodless skin snip South America near cool, fast flowing rivers Simulium/Black fly, bite during the day

Opisthorchis Chinese Liver Fluke viverrini, Opisthorchis felineus, Clonorchis sinensis bile duct

1.5 million people in Russia

consuming infected raw, slightly salted or frozen fish

Paragonimus Paragonimiasis, Lung Fluke westermani; Paragonim lungs us africanus; Paragonimus sputum, feces East Asia

ingestion of raw or undercooked freshwater crabs crayfishes or other

Common name of organism or disease

Body Latin name (sorted) parts affected Diagnostic specimen Prevalence Transmission/Vector

caliensis;Paragonimus kellicotti; Paragonimus skrjabini; Paragonimus uterobilateralis


Africa, Caribbean, Schistosomiasis - bilharzia, bilharziosis or snail fever (all Schistosoma sp. types) eastern South America, east Asia, Middle East - 200 million people skin exposure to water contaminated with infected fresh water snails

Africa, intestine, intestinal schistosomiasis Schistosoma mansoni liver, spleen, lungs, skin stool Caribbean, Asia, Middle people skin exposure to water infected Biomphalaria fr South America, contaminated with East - 83 million esh water snails

kidney, urinary schistosomiasis Schistosoma haematobium bladder, ureters, lungs, skin urine Africa, Middle East

skin exposure to water contaminated with infected Bulinus sp. snails

Schistosomiasis bySchistoso ma japonicum

intestine, Schistosoma japonicum liver, spleen, lungs, skin stool

China, East Asia, Philippines

skin exposure to water contaminated with infected Oncomelania sp. snails

skin exposure to water Asian intestinal schistosomiasis contaminated with Schistosoma mekongi South East Asia infected Neotricula aperta - fresh water snails

Common name of organism or disease

Body Latin name (sorted) parts affected Diagnostic specimen Prevalence Transmission/Vector

ingestion of material Sparganosis Spirometra erinaceieuropaei contaminated with infected dog or cat feces (humans: dead-end host)

Intestines, Strongyloidiasis - Parasitic pneumonia Strongyloides stercoralis lungs, skin (Larva currens) stool, blood skin penetration

Beef tapeworm

Taenia saginata



worldwide distribution

ingestion of undercooked beef

Pork tapeworm

Taenia solium

ingestion of undercooked pork

liver, brain, eyes (Toxocara Toxocariasis Toxocara canis, Toxocara cati canis -Visceral larva migrans, Ocul ar larva migrans) blood, ocular examination worldwide distribution pica, unwashed food contamined with Toxocara eggs, undercooked livers of chicken

more common Trichinella spiralis, Trichinella Trichinosis britovi,Trichinella nelsoni, Trichinella nativa in developing muscle, periorbital region, small intestine blood countries due to improved feeding practices in developed countries. ingestion of undercooked pork

Common name of organism or disease

Body Latin name (sorted) parts affected Diagnostic specimen Prevalence Transmission/Vector

Trichobilharzia Swimmer's itch regenti, Schistosomatid ae

skin exposure to contaminated water (snails and vertebrates)

accidental ingestion of Trichuris Whipworm trichiura, Trichuris vulpis large intestine, anus stool (eggs) eggs in dry goods such as common worldwide beans, rice, and various grains or soil contaminated with human feces

ElephantiasisLymphatic filariasis [edit]Other organisms

Wuchereria bancrofti

lymphatic system

thick blood smears stained withhematoxylin.

Tropical and subtropical

mosquito, bites at night

Common name of organism or disease Latin name (sorted) Body parts affected Diagnostic specimen Prevalence Transmission/Vector

parasitic worm


Halzoun Syndrome

Linguatula serrata


physical examination

ingestion of raw or undercooked Mid East lymph nodes (e.g., meat from infected camels and buffalos)


Oestroidea, Calliphoridae,Sarcophagidae

dead or living tissue

Chigoe flea

Tunga penetrans

Subcutaneous tissue

physical examination

Central and South America

Common name of organism or disease Latin name (sorted) Body parts affected Diagnostic specimen Prevalence Transmission/Vector

Human Botfly

Dermatobia hominis

Subcutaneous tissue

physical examination

Central and South America

Mosquitoes and biting flies


Common name of organism or disease

Body Latin name (sorted) parts affected

Diagnostic specimen




Cimicidae Cimex lectularius




sharing of clothing and bedding

Head louse - Pediculosis

Pediculus humanus

hair follicles

visual identification under magnification

Common worldwide head-to-head contact

visual identification Body louse - Pediculosis Pediculus humanus corporis under magnification (Vagabond's disease) Worldwide

skin-to-skin contact such as sexual activity and via sharing clothing or bedding

Crab louse - Pediculosis

Phthirus pubis

pubic area, eyelashes

visual identification under magnification

skin-to-skin contact such as Worldwide sexual activity and via sharing clothing or bedding

Demodex - Demodicosis

Demodex folliculorum/brevis/canis

eyebrow, eyelashes

Microscopy of eyelash or eyebrow hair follicle

Pandemic, worldwide

prolonged skin-to-skin contact


Sarcoptes scabiei


microscopy of surface scrapings

skin-to-skin contact such as Worldwide sexual activity and via sharing clothing or bedding

Common name of organism or disease

Body Latin name (sorted) parts affected

Diagnostic specimen



North America Screwworm, Cochliomyia Cochliomyia hominivorax skin and wounds visual (eradicated), Central America, North Africa direct contact with fly

Flea, Siphonaptera

Pulex irritans


visual identification under magnification



Parasite life cycles can take a variety of forms, all involving the exploitation of one or more hosts. Those that must infect more than one host species to complete their life cycles are said to have complex or indirect life cycles, while those that infect a single species have direct life cycles. If a parasite has to infect a given host in order to complete its life cycle, then it is said to be an obligate parasite of that host; sometimes, infection is facultativethe parasite can survive and complete its life cycle without infecting that particular host species. Parasites sometimes infect hosts in which they cannot complete their life cycles; these are accidental hosts. A host in which parasites have sexual reproduction is known as the definitive, final or primary host. In intermediate hosts, parasites either do not reproduce or do so asexually, but the parasite always develops to a new stage in this type of host. In some cases a parasite will infect a host, but not undergo any development, these [1] hosts are known as paratenic or transport hosts. The paratenic host can be useful in making it more likely that the parasite will be transmitted to the definitive host. For example the cat lungworm (Aelurostrongylus abstrusus) uses a slug or snail as an intermediate host; the first stage larva enters the mollusk and develops to the third stage larva, which is infectious to the definitive hostthe cat. If a mouse eats the slug, the third stage larva will enter the mouse's tissues, but will not undergo any development. Parasitic Nutrition is a mode of heterotrophic nutrition where an organism (known as a parasite) lives on the body surface or inside the body of another type of organism (known as a host). The parasite obtains nutrition directly from the body of the host. Since these parasites derive their nourishment from their host, this symbiotic interaction is often described as harmful to the host. Parasites are dependent on their host for survival, since the host provides nutrition and protection. As a result of this dependence, parasites have considerable modifications to optimise parasitic nutrition and therefore their survival. Parasites are divided into two groups: endoparasites and ectoparasites. Endoparasites are parasites that live inside the body of the host, whereas ectoparasites are parasites that live on the outer surface of the host and generally [1] attach themselves during feeding . Due to the different strategies of endoparasites and ectoparasites they require different adaptations in order to acquire nutrients from their host. Parasites require nutrients to carry out essential functions including reproduction and growth. Essentially, the nutrients required from the host are carbohydrates, amino acids and lipids. Carbohydrates are utilised to generate energy, whilst amino acids and fatty acids are involved in the synthesis of macromolecules and the production of [2] eggs . Most parasites are heterotrophs, so they therefore are unable to synthesise their own 'food' i.e. organic compounds and must acquire these from their host.

Endoparasites are parasites which live inside the body of the host. This group includes helminths, trematodes and cestodes. Endoparasites are two groups of parasites: intercellular and intracellular parasites. Intercellular parasites live in spaces within the host e.g. the alimentary canal, whereas intracellular parasites live in cells within the host e.g. erythrocytes. Intracellular parasites typically rely on a third [3][1] organism, a vector, to transmit the parasite between hosts . Rather than requiring adaptations to penetrate the host, as ectoparasites do, endoparasites are in a nutrient-rich location so they instead have adaptations to maximise nutrient absorption. Endoparasites have a readily available and renewable supply of nutrients inside the host, which in some cases is pre-digested by the host, so mechanisms of nutrient absorption across their body surface is a [1] common feature . As part of their life cycle strategy, endoparasites must also be able to transmit from within the host body and survive the hostile environment within the host. Only by achieving this can they benefit from acquiring nutrition in this way.

Microvilli structure which increases the surface area available for nutrient uptake in endoparasites

Endoparasites have various anatomical and biochemical adaptations, typically at the host-parasite interface, to maximise nutrient acquisition. One such adaptation is the tegument, a metabolically active external cover which plays [2] an important role in the acquisition of nutrients from the host . The parasite tegument is permeable to various organic solutes and has transporters for the facilitated or active uptake of nutrients. Various studies have attempted to characterise these transporters in a number of parasites e.g. the amino acid transporter molecules in [2][4][5] protozoa . Cestodes do not have a gut so the tegument is therefore critical for nutrient uptake. In cestodes the tegument is highly efficient with spine-like microtriches, similar to microvilli, to increase the surface area available for [6] nutrient acquisition . In many parasites the tegument structure has folds or microvilli to maximise the surface area available for diffusion and uptake of nutrients. The tegument also commonly has additional organelles and features with important functions in metabolism including the glycocalyx. The glycocalyx is a carbohydrate-rich layer which [7] enhances nutrient absorption and secretes enzymes to aid primary digestion . Another important adaptation of endoparasites is the gut, which digests host macromolecules into soluble utilisable [2] products . This feature is particularly important in endoparasites which are not located in the alimentary canal and therefore the supply of nutrients is not pre-digested by the host. The gut lining typically has a layer of endodermal cells which secrete proteolytic enzymes to aid digestion. Some endoparasites have both a gut and anus, some lack an anus and some have neither i.e. those residing in the alimentary canal which instead diffuse pre-digested host [2] nutrients across their body surface . The relative importance of the tegument, gut and other adaptations involved in nutrient acquisition varies between different endoparasitic species.


Head of the pork tapeworm, Taenia solium., with attachment structures to attach to the wall of the small intestine

Tapeworms are endoparasites which have numerous adaptations to enhance parasitic nutrition. Tapeworms live in the small intestine of humans, providing an ideal location to access a readily available, rich source of pre-digested [8] nutrients . Since nutrients in the small intestine are plentiful and pre-digested by the host, tapeworms do not require a gut and instead have adaptations to maximise nutrient absorption. Tapeworms have a tegument which allows nutrients to be absorbed directly from the host small intestine by diffusion. They also have anatomical adaptations in the form of a scolex with hookers and suckers to allow the parasite to attach to the host small intestine wall, [2] preventing the tapeworm from being egested following peristalsis . Tapeworms have a flattened body with microtriches to maximise the surface area available for nutrient absorption and they additionally have various transporter molecules. Tapeworms have to compete with the host epithelium for nutrients, so it is essential that they compete more efficiently for nutrients. They also secrete enzymes to enhance host digestive enzymes e.g. pancreatic [2] -amylase .

Schistosomes, another type of endoparasite, also live inside the body of the host but instead these parasites acquire their nutrients from host blood. Schistosomes are in direct contact with host blood, a rich source of amino acids, and they therefore do not require penetrative structures to reach host nutrients. Schistosomes take blood up through the [2] negative pressure created by muscle contractions of their sucker and oesophagus . They obtain amino acids from host blood through a mechanism of haemoglobin degradation, which remains unresolved but is suggested to involve [9][10] a series of proteases. Mechanisms to overcome blood clotting are also employed . Various studies have attempted to characterise the components of the schistosome tegument, including transporter molecules suggested to be involved in nutrient uptake. Such transporter molecules include schistosome alkaline phosphatase (SmAP) and [11][12][13] cathepsin B, which are suggested to be important in nutrient acquisition .

Malaria, caused by the apicomplexan parasite Plasmodium falciparum, is an intracellular endoparasite. This parasite relies on a third organism, in the form of an Anopheles mosquito vector. The host blood provides an ideal rich source of glucose and amino acids to the parasite, particularly during blood stage infection [14] where Plasmodium infects erythrocytes . In order to acquire essential nutrients Plasmodiumhas to compete with both the vertebrate and insect host and therefore must be highly efficient, regulating uptake according to nutrient [14] availability . Plasmodium, along with many other endoparasitic parasites, have numerous channels in their parasitophorous vacuole membrane rendering it permeable to organic solutes to allow the uptake of necessary nutrients. The Plasmodium falciparum hexose transporter (PfHT) is such a transporter, which is critical for the uptake [15] of glucose and fructose and therefore survival of the parasite . These organic molecules have to cross three membranes altogether; the plasma membrane of the erythrocyte, the parasitophorous vacuole membrane and [16] the Plasmodium plasma membrane, facilitated by transporters such as PfHT .

Ectoparasites live on the outer surface of the host. This group includes ticks, leeches, mites and the tsetse fly. Ectoparasites do not have a readily available source of nutrients available on the outer surface of the host so they therefore require adaptations which enable them to gain access to host nutrients. This requires penetrative features which can insert into the host, as well as the ability to secrete digestive enzymes and the presence of a gut to digest [1] host-derived nutrients . Ectoparasites also have a variety of parasite transporters and permeases to enable them to acquire nutrition from their host, across numerous membranes. Many ectoparasites are known to be vectors of [17] pathogens, so they therefore transmit these pathogens during nutrient acquisition . Tsetse flies, the insect vector of Trypanosoma brucei, the causative agent of African trypanosomiasis are an example of an ectoparasite. These insects have specialised structures, known as a proboscis to pierce and draw nutrients from their host. These then employ transport proteins to transport the essential nutrients across membranes,

ultimately from the host to the tsetse fly gut for digestion. Various permeases have been characterised including [18][19] those that import hexoses, carboxylates, and amino acids . Another endoparasite is scabies, caused by Sarcoptes scabiei. Scabies, transmitted by female mites, depends on nutrition from its host for survival. This endoparasite obtains nutrients by burrowing into the skin of the host. Studies have also identified the presence of scabies mite inactivated protease paralogues (SMIPPs), which are believed to [20] compete with host proteases .

Effects on the host

As mentioned previously, parasitic nutrition is beneficial to the parasite but typically detrimental to the host since it deprives the host of nutrients. This mode of nutrition has numerous side effects on the host including weight loss, anaemia, obstruction of the intestine, damage to the host intestinal wall and in some cases transmission of serious [1][14][2][21] pathogens e.g. the ectoparasitic tsetse fly which transmits African trypanosomiasis .

Nutrient acquisition is an important component of parasite pathogenesis since it is critical to parasite survival . Understanding the mechanisms of parasite nutrient acquisition therefore identifies novel targets which we can exploit as a form of parasite control e.g. through knock-out or inhibition of crucial transporters or destruction of penetrative anatomical features. Several studies have looked into nutrient acquisition as a method of parasite control, including [22] the development of vaccines against helminth parasites by targeting digestive proteases .

Parasitic nutrition in plants

Plants are typically autotrophic organisms meaning that they synthesise their own 'food' from inorganic compounds by photosynthesis. Some plants however are unable to synthesise their own 'food' by photosynthesis and therefore acquire nutrients by parasitic nutrition from other living plants. Plants which acquire their nutrients in this way are [23] known as parasitic plants . These plants have modified root structures known as haustorium, which the parasitic [24][1] plants use to penetrate the vascular bundle of host plants and essentially 'steal' nutrients from host plants . Parasitic plants include Dodder, Rafflesia and Broomrape.