Department of Radiology and Imaging, Grant Medical Foundation, Maharashtra, India.
Br J Radiol. 2011 Jun;84(1002):e126-9. doi: 10.1259/bjr/84379927.
We report a rare case of a 32-year-old male with live extralymphatic filarial infestation presenting as a facial subcutaneous soft-tissue swelling. To the best of our knowledge these imaging findings have not been previously reported in the head and neck region in the existing English language literature. Real-time high-resolution ultrasonography revealed a solitary well-defined subcutaneous cystic lesion over the right zygomatic arch. It showed multiple linear, echogenic, undulating structures exhibiting a persistent twirling motion during the examination. This typical ultrasonographic appearance was consistent with the filarial dance sign (FDS) of live adult filarial worms. Subsequent MRI confirmed the cystic and solitary nature of the lesion. Complete excision of the cyst was performed, which revealed intracystic straw-coloured fluid and multiple white-coloured adult worms within the lesion. Histopathological examination confirmed multiple adult filarial worms with surrounding reactive inflammatory changes. In an endemic region, identification of the FDS in any normal anatomical structure or abnormal swelling, however remote or unusual the location within the body, should strongly suggest the diagnosis of live active filarial infestation. In view of the increasing migratory trends in the global population, it is imperative for radiologists in all countries to be aware of the typical imaging findings of this disease to arrive at the correct diagnosis.
我们报告了 1 例罕见的 32 岁男性活丝虫外淋巴寄生病例，表现为面部皮下软组织肿胀。据我们所知，这些影像学表现以前在现有的英文文献中尚未在头颈部报道过。实时高分辨率超声显示右颧骨上方有一个孤立的、边界清楚的皮下囊性病变。它显示出多个线性、回声增强、波浪状结构，在检查过程中表现出持续的旋转运动。这种典型的超声表现与活成虫丝虫的丝虫舞蹈征（FDS）一致。随后的 MRI 证实了病变的囊性和孤立性。对囊肿进行了完全切除，发现囊内有稻草色的液体和病变内有多条白色的成虫。组织病理学检查证实了多个成虫丝虫，伴有周围的反应性炎症改变。在流行地区，在任何正常解剖结构或异常肿胀中发现 FDS，无论身体的位置多么遥远或不寻常，都应强烈提示活虫感染的诊断。鉴于全球人口的迁移趋势不断增加，所有国家的放射科医生都必须了解这种疾病的典型影像学表现，以便做出正确的诊断。
