Yuan Wei-Hsin, Lee Rheun-Chuan, Chou Yi-Hong, Chiang Jen-Huey, Chen Yuh-Kuen, Hsu Hui-Chen
Department of Radiology, Taipei Veterans General Hospital, National Yang Ming University, Taipei, Taiwan.
Kaohsiung J Med Sci. 2005 Sep;21(9):418-23. doi: 10.1016/S1607-551X(09)70144-5.
Taiwan is nearly free from hydatid disease. We report a case of hydatid cyst of the liver in a 37-year-old man who originally lived in India and had migrated to Taiwan 2 years earlier. He presented with right upper quadrant pain and intermittent low-grade fever. Both sonography and computed tomography (CT) demonstrated a cystic lesion with vesicles at its periphery in segments 6 and 7 of the liver. A hydatid cyst was diagnosed. The patient underwent radical excision of the cyst with total removal without opening the wall. He also received pre- and postoperative oral mebendazole. Pathology showed a hydatid cyst consisting of three layers: the inner single nucleated geminal layer, the middle acellular laminated layer, and the outer pericyst originating from inflammatory and hepatic cells. This case highlights that accurate preoperative diagnosis of hydatid disease can be made from personal history, typical sonography and CT study in non-endemic areas.
台湾地区几乎没有包虫病。我们报告一例37岁男性肝包虫囊肿病例,该患者原居住在印度,两年前移民至台湾。他表现为右上腹疼痛和间歇性低热。超声检查和计算机断层扫描(CT)均显示肝脏第6和第7段有一个周边有小泡的囊性病变。诊断为肝包虫囊肿。患者接受了囊肿根治性切除术,完整切除且未打开囊壁。他还在术前和术后口服了甲苯咪唑。病理显示包虫囊肿由三层组成:内层为单核生发层,中层为无细胞板层,外层为源自炎症细胞和肝细胞的外膜。该病例强调,在非流行地区,通过个人病史、典型的超声检查和CT研究可对包虫病做出准确的术前诊断。