Kim Min Kyung, Kim Chul Hwan, Yeom Beom Woo, Park Seong Hwan, Choi Sang Yong, Choi Jong Sang
Department of Pathology, Guro Hospital, Korea University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2002 Oct;17(5):686-90. doi: 10.3346/jkms.2002.17.5.686.
Most of human dirofilariasis are pulmonary or subcutaneous infections, but there have been a few reports of human dirofilariasis in unusual sites, such as large vessels, mesentery, peritoneal cavity, and spermatic cord. We present the first case of human hepatic dirofilariasis, which was surgically diagnosed. A 39-year-old man without any evidence of systemic symptom was found incidentally to have a hepatic nodule during routine physical check-up. The histologic findings of the resected lesion showed a granulomatous lesion with central necrosis containing up to 35 transverse sections of a nematode, ranging 30-80 micro m in diameter. Thin (1.5-5 micro m) cuticle with transverse striations surrounded polymyarian and muscle bundles occupied a sixth of both sides of outer body cavity. Central portion of the body cavity was occupied with an intestine-like tubular structure and a larger reproductive tube. These microscopic findings were consistent with degenerated Dirofilaria immitis. Antibody test by enzyme-linked immunosorbent assay for patient serum reacted positively against adult D. immitis antigen.
大多数人体丝虫病为肺部或皮下感染，但也有少数关于人体丝虫病发生在不寻常部位的报道，如大血管、肠系膜、腹腔和精索。我们报告首例经手术诊断的人体肝丝虫病病例。一名39岁男性在常规体检时偶然发现肝脏有一个结节，无任何全身症状的证据。切除病变的组织学检查结果显示为肉芽肿性病变，中央坏死，含有多达35个线虫横切面，直径为30 - 80微米。薄（1.5 - 5微米）的角质层有横纹，围绕着多肌型和肌肉束，占据体腔外侧两侧的六分之一。体腔中央部分被类似肠道的管状结构和一个较大的生殖管所占据。这些显微镜检查结果与退化的犬恶丝虫一致。通过酶联免疫吸附试验对患者血清进行的抗体检测对成年犬恶丝虫抗原有阳性反应。
