Mizutani Eiki, Morita Riichiro, Hanaoka Shigenori, Okochi Yasumi, Tokuda Hitoshi, Kitamura Shigehiro
Department of Thoracic Surgery, Social Insurance Central General Hospital, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2010 Dec;16(6):436-8.
Pleuropulmonary paragonimiasis is a food-borne parasitic disease caused by the lung fluke Paragonimus westermani or other species of Paragonimus, which is endemic in Southeast Asia. It presents mainly pleural effusion or intrapulmonary nodules with respiratory symptoms. However, here we describe an exceedingly rare case of Paragonimus westermani with a mass in the pleural cavity. A 47-year-old man, who had presented with chest pain nine months earlier, was found to have right pleural effusion on detection survey computed tomography. He had a history of asbestos exposure and river fishing as a hobby and was confirmed to have Paragonimus westermani by immunodiagnosis. Because of a high level of hyaluronic acid in pleural effusion, he underwent a thoracoscopic examination. The pleura of the thoracic wall thickened greatly and showed no malignant lesion on biopsy. A white mass measuring 8 cm in diameter showed in the pleural cavity, which partially connected with the diaphragm and pulmonary pleura of the lower lobe. The postoperative pathological examination reported that the intrathoracic mass was a lesion that contained necrotic tissue enveloped with a fibrin capsule, which was thought to be formed by paragonimus.
肺吸虫病是一种食源性寄生虫病，由卫氏并殖吸虫或其他并殖吸虫物种引起，在东南亚地区呈地方性流行。其主要表现为胸腔积液或肺内结节，并伴有呼吸道症状。然而，在此我们描述一例极为罕见的卫氏并殖吸虫病例，该病例在胸腔内形成了肿块。一名47岁男性，九个月前出现胸痛症状，在检测性计算机断层扫描中发现有右侧胸腔积液。他有石棉接触史，且有河边捕鱼的爱好，经免疫诊断确诊为卫氏并殖吸虫感染。由于胸腔积液中透明质酸水平较高，他接受了胸腔镜检查。胸壁胸膜明显增厚，活检未发现恶性病变。胸腔内可见一个直径8厘米的白色肿块，部分与膈肌及下叶肺胸膜相连。术后病理检查报告显示，胸腔内肿块是一个包含坏死组织且被纤维蛋白包膜包裹的病变，推测为由肺吸虫形成。
