Marcos Luis A, Légua Pedro, Sánchez Juvenal, Espinoza José R, Yi Pedro, Tantaleán Manuel
Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Urb. Ingeniería, San Martín de Porres AP 4314, Lima 100, Perú.
Trans R Soc Trop Med Hyg. 2009 Mar;103(3):318-20. doi: 10.1016/j.trstmh.2008.10.024. Epub 2008 Nov 28.
A 58-year-old man presented with an asymptomatic 5cm left anterior cervical tumor that had been present for over a year. Histological analysis revealed chronic inflammation and granuloma with giant cells surrounding Fasciola hepatica eggs. Fas2 antigen was detected in the tissue by immunohistochemistry. Serology for F. hepatica was positive, but stool examinations were negative and eosinophil count was normal. A month later, the tumor recurred, and an adult parasite was found during excision. The patient received triclabendazole, and after 6 months serology was negative. Erratic localization of F. hepatica reveals a pathology involving chronic inflammation caused by a sexually mature parasite, although according to theory only immature parasites are located in ectopic lesions.
一名58岁男性患者,左前颈部出现一个无症状的5厘米肿瘤,已存在一年多。组织学分析显示慢性炎症和肉芽肿,伴有围绕肝片吸虫卵的巨细胞。通过免疫组织化学在组织中检测到Fas2抗原。肝片吸虫血清学检测呈阳性,但粪便检查为阴性,嗜酸性粒细胞计数正常。一个月后,肿瘤复发,切除过程中发现一条成虫。患者接受了三氯苯达唑治疗,6个月后血清学检测呈阴性。肝片吸虫的异位定位揭示了一种由性成熟寄生虫引起的慢性炎症病理,尽管根据理论,异位病变中仅存在未成熟寄生虫。