Eccher Albino, Dalfior Daniela, Gobbo Stefano, Martignoni Guido, Brunelli Matteo, Decaminada Walter, Bonetti Franco, Rivasi Francesco, Barbareschi Mattia, Menestrina Fabio
Anatomia Patologica, Dipartimento di Patologia, Università di Verona, Italy.
Int J Surg Pathol. 2008 Jan;16(1):101-3. doi: 10.1177/1066896907307040.
Dirofilariasis is a zoonotic infection, which is occasionally seen in humans and rarely found as a subcutaneous orbital swelling. The authors report a case of a 62-year-old woman presented with a 3-month history of a right periorbital subcutaneous nodule. Treatment with antibiotics and corticosteroids was not satisfactory. Magnetic resonance imaging analysis showed a nodule with a central colliquative area. The lesion displaced the eyeball superiorly but did not affect the intraorbital muscles. The patient was subjected to excisional biopsy and the nodule measured 15 mm. Histological findings showed microabscess reaction with heterogeneous lymphoid infiltration. Additional consecutive sections finally showed Dirofilaria repens, curled up in spirals with external cuticular ridges in an environment characterized by epithelioid cells. The lesion did not recur for 5 months. Periorbital swelling can be rarely caused by Dirofilaria repens; therefore, this diagnosis should be considered in all cases of subcutaneous inflammatory or tumor-like lesion of unknown etiology.
丝虫病是一种人畜共患感染病，偶尔在人类中出现，极少表现为皮下眼眶肿胀。作者报告了一例62岁女性患者，有3个月的右侧眶周皮下结节病史。使用抗生素和皮质类固醇治疗效果不佳。磁共振成像分析显示一个有中央液化区的结节。该病变使眼球向上移位，但未影响眶内肌肉。患者接受了切除活检，结节大小为15毫米。组织学检查结果显示有微脓肿反应和异质性淋巴浸润。额外的连续切片最终显示为匐行恶丝虫，在以类上皮细胞为特征的环境中呈螺旋状卷曲，体表有外部角质嵴。病变在5个月内未复发。眶周肿胀极少由匐行恶丝虫引起；因此，对于所有病因不明的皮下炎症或肿瘤样病变病例均应考虑这一诊断。
