Department of Obstetrics and Gynecology, University Hospital of Cologne, Germany ; CIO Cologne-Bonn, Breast Center, Ludwig Maximilian's University Munich, Germany.
University Hospital of Munich, Breast Center, Ludwig Maximilian's University Munich, Germany ; University Hospital of Munich, Comprehensive Cancer Center, Ludwig Maximilian's University Munich, Germany.
Breast Care (Basel). 2012 Dec;7(6):487-9. doi: 10.1159/000345471.
The term filariasis comprises a group of parasitic infections caused by helminths belonging to different genera in the superfamily Filaroidea. The human parasites occur mainly in tropical and subtropical regions, but filariae are also found in temperate climates, where they can infect wild and domestic animals. Humans are rarely infected by these zoonotic parasites.
A 55-year-old patient presented with a new-onset, subcutaneous, non-tender palpable mass in the right axilla. Ultrasonography showed a 1.3-cm, solid, singular encapsulated node. Sonography of the breast on both sides, axilla and lymphatic drainage on the left side, lymphatic drainage on the right side, and mammography on both sides were without pathological findings. The node was excised under local anesthesia as the patient refused minimal invasive biopsy.
On histopathological examination, the tail of a parasite of the group of filariae was found. The patient revealed that she had stayed in Africa and Malaysia for professional reasons. 6 months before the time of diagnosis, she had also suffered from a fever and poor general condition after a trip abroad. The patient was referred for further treatment to the Institute for Tropical Medicine at the University of Dusseldorf, where a treatment with ivermectin was conducted on the basis of positive staining with antibodies against filariae.
Our case demonstrates the importance of interdisciplinary collaboration between breast center, pathology, and other specialties such as microbiology and tropical medicine.
丝虫病一词包括一组由不同属的线虫引起的寄生虫感染，这些线虫属于丝虫超科。人类寄生虫主要出现在热带和亚热带地区，但丝虫也存在于温带气候中，在那里它们可以感染野生动物和家养动物。人类很少被这些人畜共患寄生虫感染。
一名 55 岁女性患者出现右侧腋窝新发、皮下、无痛可触及的肿块。超声显示 1.3 厘米实性孤立包膜结节。双侧乳房超声、腋窝和左侧淋巴引流、右侧淋巴引流和双侧乳房 X 线摄影均无病理发现。由于患者拒绝微创活检，在局部麻醉下切除了该结节。
在组织病理学检查中，发现了一组丝虫的尾部。患者表示，她曾因职业原因在非洲和马来西亚逗留。在诊断前 6 个月，她在一次出国旅行后也出现了发热和全身状况不佳的情况。患者被转介到杜塞尔多夫大学热带医学研究所进一步治疗，根据对丝虫的抗体呈阳性染色，进行了伊维菌素治疗。
我们的病例表明，乳腺中心、病理学以及微生物学和热带医学等其他专业之间的跨学科合作非常重要。
