Ye Xiwen, Xiong Xianze, Cheng Nansheng, Lu Jiong, Lin Yixin
Department of Bile Duct Surgery, Sichuan University West China Medical Center, Chengdu, Sichuan, China.
Gastroenterol Rep (Oxf). 2017 Nov;5(4):282-287. doi: 10.1093/gastro/gox008. Epub 2017 Apr 16.
In paragonimiasis, the lungs and pleural cavity are the major target organs, and the central nervous system can also be affected. The liver is an organ in which ectopic paragonimiasis rarely occurs. Because the symptoms and examinations in hepatic paragonimiasis (HP) are not typical, the disease is often misdiagnosed in the clinic.
From February 2008 to March 2015, our department accepted 32 patients who presented with a liver mass upon ultrasound and computed tomography imaging and in whom the source of the mass could not be identified upon numerous further diagnostic tests. We ultimately obtained surgical biopsies of their lesions for pathological examination. We analysed the clinical data of these cases, along with their disease characteristics, the diagnostic strategies employed and their treatment experiences. Additionally, we performed patient follow-up for a period of 6-12 months.
All patients underwent half/partial hepatectomy and were diagnosed with HP upon pathological examination. They recovered well after surgery and their original symptoms were markedly improved without recurrence. The liver functions of the patients reached normal levels before discharge and no additional liver lesions were found upon diagnostic imaging.
The diagnosis of HP based on clinical manifestations, laboratory tests or image examination is difficult and only pathologic analysis of biopsies could confirm HP. Surgical treatment not only removes lesions, but also allows for pathologic biopsy. This study encompasses the largest number of HP patients to date, but the surgical outcomes require further research and long-term follow-up.
在肺吸虫病中，肺和胸腔是主要靶器官，中枢神经系统也可受累。肝脏是异位肺吸虫病很少发生的器官。由于肝肺吸虫病（HP）的症状和检查不典型，该病在临床上常被误诊。
2008年2月至2015年3月，我科收治了32例经超声和计算机断层扫描成像显示肝脏有肿块且经过多次进一步诊断检查仍无法确定肿块来源的患者。我们最终获取了他们病变的手术活检组织进行病理检查。我们分析了这些病例的临床资料、疾病特征、采用的诊断策略及其治疗经验。此外，我们对患者进行了6至12个月的随访。
所有患者均接受了半肝/部分肝切除术，病理检查确诊为HP。术后恢复良好，原有症状明显改善，无复发。患者肝功能在出院前恢复正常，诊断性影像学检查未发现新的肝脏病变。
基于临床表现、实验室检查或影像学检查诊断HP较为困难，只有活检的病理分析才能确诊HP。手术治疗不仅能切除病变，还能进行病理活检。本研究涵盖了迄今为止数量最多的HP患者，但手术结果仍需进一步研究和长期随访。
