Schistosomiasis due to Schistosoma intercalatum is highly restricted to
the Western regions of equatorial Africa. Its main clinical manifestation is
rectal bleeding. A case is described of a 14 year old boy living in Upper
Egypt who was presented to General Surgery Department, Sohag
University Hospital, South Valley University, complaining of vague
abdominal pain, rectal bleeding, multiple abdominal masses and
splenomegaly. Laparotomy revealed moderate splenomegaly, multiple
hepatic focal lesions, mesenteric and paracolic lymphadenopathy, and
multiple nonobstructing colonic masses. Splenectomy was done, multiple
lymph node biopsies and wedge liver biopsy were taken. Endoscopic rectal
biopsy was also done. The primary diagnosis was abdominal lymphoma
with hepatic and splenic involvement. Histopathological examinations of
these biopsies revealed congested spleen and multiple bilharzial
granulomata effacing the whole lymph nodal architecture, infiterating the
portal tracts of the liver, and surrounding terminally spined-eggs of the
rectal wall. Staining of the rectal specimen by Modified Ziehl-Neelsen
showed red coloration of the egg-shell characteristic of S.intercalatum. We
here announce the first record of S. intercalatum in Upper Egypt, Sohag
Governorate and also report an interesting unusual presentation of S.
intercalatum schistosomiasis by abdominal lymph node enlargement
simulating lymphoma.