Ferrari Paolo Albino, Grisolia Antonella, Reale Stefano, Liotta Rosa, Mularoni Alessandra, Bertani Alessandro
Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS ISMETT, Via Tricomi 5, Palermo, Italy.
Division of Thoracic Surgery, "A. Businco" Oncology Hospital - Azienda Ospedaliera Brotzu, Via Jenner 1, 09100, Cagliari, Italy.
J Cardiothorac Surg. 2018 Jun 11;13(1):65. doi: 10.1186/s13019-018-0750-5.
Human pulmonary dirofilariasis is a rare zoonosis caused by the dog worm Dirofilaria spp., a parasite transmitted by mosquitos and resulting in peripheral lung nodules. The filarial nematode enters the subcutaneous tissue, travels to the right ventricle and dies causing a small pulmonary infarction that may embolize through the pulmonary vessels and may appear as a solitary nodule. These nodules are usually incidentally identified in asymptomatic patients undergoing chest imaging studies, and are generally interpreted to be malignant.
We present the case report of a human dirofilariasis in a patient with multiple pulmonary nodules resected using video-assisted thoracic surgery (VATS). According to our literature review, this is the first case with double synchronous lung nodules reported in Italy.
Minimally invasive resection with histologic examination may be the best approach for the diagnosis and treatment of pulmonary dirofilariasis. Polymerase Chain Reaction testing may provide a more accurate etiological diagnosis in case of an inconclusive pathology result.
人类肺丝虫病是一种由犬恶丝虫属引起的罕见人畜共患病，该寄生虫由蚊子传播，可导致周围肺结节。丝虫线虫进入皮下组织，进入右心室并死亡，导致小的肺梗死，可能通过肺血管发生栓塞，并可能表现为孤立性结节。这些结节通常在进行胸部影像学检查的无症状患者中偶然发现，通常被认为是恶性的。
我们报告了一例使用电视辅助胸腔镜手术（VATS）切除多个肺结节的人类丝虫病病例。根据我们的文献综述，这是意大利报道的首例双发性同步肺结节病例。
微创切除并进行组织学检查可能是诊断和治疗肺丝虫病的最佳方法。在病理结果不明确的情况下，聚合酶链反应检测可能提供更准确的病因诊断。
