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无症状孤立性肺结节的罕见病因:成人血吸虫

A rare cause of asymptomatic solitary pulmonary nodule: adult Schistosoma worm.

作者信息

Chaudhry Ikram Ulhaq, Manah Wejdan, Alghamdi Mohammed, Mutairi Hadi

机构信息

Department of Chest Surgery, King Fahad Specialist Hospital, Dammam, Saudi Arabia.

出版信息

BMJ Case Rep. 2014 Mar 10;2014:bcr2013202840. doi: 10.1136/bcr-2013-202840.

Abstract

Solitary pulmonary nodule due to various pathologies has been reported in the medical literature. We report a case of solitary pulmonary nodule in an asymptomatic 60-year-old male smoker, who had a positive family history of pulmonary tuberculosis. His routine screening chest X-ray revealed a 2 × 1.5 cm nodule in the right lung upper zone. A CT scan of the thorax confirmed the finding. Bronchoscopy, lavage, biopsy and screening for tuberculosis were negative. Owing to its technical difficulty, a CT-guided biopsy was deferred by the radiologist, hence we decided to perform segmentectomy that showed granuloma harbouring an adult Schistosoma worm. This is the first case of asymptomatic solitary pulmonary nodule due to adult Schistosoma worm 26 years after the exposure.

摘要

医学文献中已报道了由各种病理情况导致的孤立性肺结节。我们报告一例60岁无症状男性吸烟者的孤立性肺结节病例,该患者有肺结核家族史。他的常规胸部X线筛查显示右肺上叶有一个2×1.5厘米的结节。胸部CT扫描证实了这一发现。支气管镜检查、灌洗、活检及结核病筛查均为阴性。由于技术难度,放射科医生推迟了CT引导下的活检,因此我们决定进行肺段切除术,结果显示肉芽肿内有一条成年血吸虫。这是暴露26年后由成年血吸虫导致无症状孤立性肺结节的首例病例。

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本文引用的文献

3
Human schistosomiasis.人类血吸虫病
Lancet. 2006 Sep 23;368(9541):1106-18. doi: 10.1016/S0140-6736(06)69440-3.
5
The solitary pulmonary nodule.孤立性肺结节
Radiology. 2006 Apr;239(1):34-49. doi: 10.1148/radiol.2391050343.
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Pulmonary schistosomiasis.肺血吸虫病
Clin Chest Med. 2002 Jun;23(2):433-43. doi: 10.1016/s0272-5231(01)00013-2.
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Acta Trop. 2000 Oct 23;77(1):41-51. doi: 10.1016/s0001-706x(00)00122-4.
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Schistosomiasis in Lake Malawi.马拉维湖的血吸虫病
Lancet. 1996 Nov 9;348(9037):1274-8. doi: 10.1016/S0140-6736(96)01511-5.

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