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韩国罕见病例:疑似寄生性肝囊肿患者放射学和免疫诊断检查综合解读的临床意义

Clinical Implications for the Comprehensive Interpretation of Radiologic and Immunodiagnostic Tests in Patients Suspected of Parasitic Hepatic Cyst, a Rare Case in Korea.

作者信息

Yoo Jae-Sung, Kang Min-Kyu, Park Jung-Gil, Kim Hyung-Joo, Choi Joon-Hyuk

机构信息

Department of Internal Medicine, Yeungnam University Medical Center, Daegu 42415, Republic of Korea.

Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Republic of Korea.

出版信息

Trop Med Infect Dis. 2023 Mar 2;8(3):155. doi: 10.3390/tropicalmed8030155.

DOI:10.3390/tropicalmed8030155
PMID:36977156
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10052134/
Abstract

Cystic echinococcosis (CE) is a representative neglected tropical disease (NTD) with increased morbidity and mortality but is ignored and overlooked in developed countries. Serological and radiographic findings are helpful in distinguishing these parasites; however, conflicting results of these can make it difficult to diagnose if medical knowledge of hepatic parasitic disease, including the etiology, features of imaging, and immunodiagnostic test, is not acquired. We report the case of a male patient with dyspepsia and right epigastric pain who had positive results for cysticercosis antibodies on immunodiagnostic examination. Abdominal ultrasonography revealed two huge communicating cystic lesions measuring 8-11 cm. Further evaluations for cysticercosis of the brain (neurocysticercosis) and eyes (intraocular cysticercosis) were unremarkable throughout the brain imaging test and fundus examination. A laparoscopic right hemi-hepatectomy was performed for diagnosis and treatment. On histopathological examination, diverse stages of were identified. Albendazole was administered postoperatively, and the patient was also followed up. We should be aware of the etiologies that have been prevalent in parasite infection thought to be the cause of hepatic cysts. Moreover, we make an effort to ascertain the patient's nationality, past travel experiences, and immediate environment, including any animals and pets. We present the case of a patient who was worried about the possibility of liver invasion of cysticercus due to the positivity of the cysticercosis antibody and was ultimately diagnosed with CE.

摘要

囊型包虫病(CE)是一种典型的被忽视的热带病(NTD),其发病率和死亡率不断上升,但在发达国家却被忽视和 overlooked(原文此处可能有误,推测应为“被忽视”)。血清学和影像学检查结果有助于鉴别这些寄生虫;然而,如果不掌握肝寄生虫病的医学知识,包括病因、影像学特征和免疫诊断检测,这些检查结果相互矛盾可能会导致诊断困难。我们报告一例男性患者,有消化不良和右上腹疼痛症状,免疫诊断检查囊尾蚴病抗体呈阳性。腹部超声检查发现两个巨大的相互连通的囊性病变,大小为8 - 11厘米。在整个脑部成像检查和眼底检查中,对脑部囊尾蚴病(神经囊尾蚴病)和眼部囊尾蚴病(眼内囊尾蚴病)的进一步评估均无异常。为明确诊断和治疗进行了腹腔镜右半肝切除术。组织病理学检查发现了不同阶段的[此处原文可能缺失内容]。术后给予阿苯达唑治疗,并对患者进行了随访。我们应该了解被认为是肝囊肿病因的寄生虫感染的常见病因。此外,我们要努力确定患者的国籍、既往旅行经历以及直接环境,包括任何动物和宠物。我们报告了一例因囊尾蚴病抗体阳性而担心囊尾蚴侵犯肝脏,最终被诊断为囊型包虫病的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b3/10052134/b1ac8b4d93a4/tropicalmed-08-00155-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b3/10052134/ae63c9ed78c4/tropicalmed-08-00155-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b3/10052134/e895bae51a85/tropicalmed-08-00155-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b3/10052134/b1ac8b4d93a4/tropicalmed-08-00155-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b3/10052134/ae63c9ed78c4/tropicalmed-08-00155-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b3/10052134/e895bae51a85/tropicalmed-08-00155-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/61b3/10052134/b1ac8b4d93a4/tropicalmed-08-00155-g003.jpg

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Am J Trop Med Hyg. 2021 Dec 13;106(2):724-728. doi: 10.4269/ajtmh.21-0261.
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An Imported Case of Disseminated Echinococcosis in Korea.韩国一例播散性棘球蚴病输入病例。
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An updated review of cystic hepatic lesions.肝脏囊性病变的最新综述。
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