Severe biliary hyperplasia associated with liver fluke infection in an adult alpaca

An adult alpaca (Lama pacos) had a locally extensive area of hepatic atrophy involving the right lobe. Grossly, the atrophic lobe was light tan and firm and contained small, raised, white to yellow, partially mineralized circular nodules predominantly at the periphery of the atrophic tissue. Microscopically, viable hepatocytes were not present in the atrophic area, and the tissue consisted of diffuse biliary epithelial proliferation without any evidence of nuclear or cellular atypia or the presence of mitotic figures. The circular mineralized nodules consisted of granulomatous inflammation with intralesional parasitic ova surrounded by fibrous connective tissue. Morphologically, the ova were compatible with those of Fasciola hepatica. The severe biliary hyperplasia was unusual, and it was not clear whether it was caused by an aberrant host response to the parasitic infection or whether it was an unrelated event.