Aoki Takanori, Hagiwara Masahiro, Yabuki Hidehiko, Ito Akira
Department of Surgery, Hokkaido Kouseiren Engaru-Kousei General Hospital, Engaru, Japan.
Department of Parasitology, Asahikawa Medical University, Asahikawa, Japan.
BMJ Case Rep. 2015 Feb 19;2015:bcr2014208123. doi: 10.1136/bcr-2014-208123.
CT scan and ultrasonography images revealed two small uniformly low-density and hypoechoic lesions in the liver, respectively, 7 years after curative resection of rectal cancer, in a 74-year-old man. The area of the liver including the two lesions was segmentally resected. Two lesions were histopathologically confirmed as early but active stage alveolar echinococcosis (AE) caused by accidental ingestion of eggs of the fox tapeworm, Echinococcus multilocularis. This case is very unique and rare, since early stage hepatic AE cases have only accidentally been confirmed from cases in which malignant hepatic tumours were suspected, and because two independent AE lesions were detected. Abdominal MRI showed two isointense tumour lesions with small areas of high-signal intensity in their centres on T2-weighted images. MRI findings appear to reflect the macroscopic view and microscopic findings of early stage AE with active cyst in the centre of each hepatic lesion well.
一名74岁男性在直肠癌根治性切除术后7年，CT扫描和超声检查图像分别显示肝脏有两个小的均匀低密度和低回声病变。包括这两个病变的肝脏区域被分段切除。两个病变经组织病理学证实为早期但活跃期的肺泡型肝包虫病（AE），由意外摄入多房棘球绦虫的虫卵引起。该病例非常独特且罕见，因为早期肝AE病例仅在怀疑有恶性肝肿瘤的病例中偶然得到确诊，并且检测到了两个独立的AE病变。腹部MRI在T2加权图像上显示两个等信号肿瘤病变，其中心有小面积高信号强度区域。MRI表现似乎很好地反映了每个肝病变中心有活跃囊肿的早期AE的宏观和微观表现。
