Pampiglione S, Rivasi F, Canestri-Trotti G
Dipartimento di Sanità Pubblica Veterinaria e Patologia Animale, Università di Bologna, Italy.
Diagn Microbiol Infect Dis. 1999 May;34(1):57-64. doi: 10.1016/s0732-8893(98)00164-3.
The authors have conducted a histologic study of over 90 cases of Dirofilaria infection in man due to Dirofilaria repens, the most extensive study of its kind in the world. On the basis of their findings, they illustrate the diagnostic difficulties that may arise when regressive phenomena render the parasite's morphologic characteristics largely or completely unrecognizable. These phenomena are due to the death of the filaria inside the inflammatory nodule weeks or months prior to surgical removal, and to the consequent invasion of inflammatory cells. They start at the nematode's natural orifices (mouth, vulva, anus, cloaca) and gradually spread throughout its body. In cases of difficult diagnosis, therefore, it is recommended that the nodule be sectioned at different points comprising caudal, cephalic and middle body aspects, so as to reveal the few morphologic features that are still recognizable and which may afford a correct diagnosis. The authors present examples of histologic sections in color plates in which the nematode was in an excellent state of preservation and others illustrating the full range of regressive phenomena, from slight to total disintegration of the bodily structure.
作者对90多例因匐行恶丝虫感染人类的病例进行了组织学研究，这是世界上同类研究中规模最大的。基于他们的研究结果，作者阐述了当退行性现象导致寄生虫的形态特征大部分或完全无法辨认时可能出现的诊断困难。这些现象是由于丝虫在手术切除前数周或数月在炎性结节内死亡，以及随之而来的炎性细胞浸润所致。它们从线虫的自然开口（口、外阴、肛门、泄殖腔）开始，逐渐蔓延至全身。因此，在诊断困难的病例中，建议在结节的不同部位进行切片，包括尾部、头部和身体中部，以便揭示仍可辨认的少数形态特征，从而做出正确诊断。作者在彩色图版中展示了组织切片的实例，其中线虫保存完好，还有一些展示了从身体结构轻微退变到完全解体的各种退行性现象。
