Kinoshita K, Koga T
No Shinkei Geka. 1986 Apr;14(5):669-72.
In Japan more than 400 cases of intracranial invasion of Paragonimus westermani have been reported. In recent years, however, because of the decrease of incidence of parasitic disease, erroneous diagnosis is apt to be made. Peculiar but characteristic calcified cystic lesions in chronic stage of cerebral paragonimiasis were described as "soap bubble appearance" in x-rays by Oh in 1968. We report such a case with calcified lesions of soap bubble appearance in plain x-ray films in the right parieto-occipital region. The patient was a 30-year-old man who had generalized convulsive seizures since childhood. CT scan revealed these lesions to have high density in the margin and relatively low density in the center. Recently some cases of cerebral involvement by Paragonimus miyazakii were reported in Japan. The immunoserological tests are most useful for the diagnosis of paragonimiasis. Bithionol administration is the treatment of choice in acute stage. Calcified lesions with positive serological tests in two years after the onset of cerebral signs should be removed surgically, if possible.
在日本,已报告400多例卫氏并殖吸虫颅内侵犯病例。然而近年来,由于寄生虫病发病率下降,容易出现误诊。1968年,Oh在X线片中将脑型并殖吸虫病慢性期特有的、具有特征性的钙化囊性病变描述为“肥皂泡样表现”。我们报告1例右顶枕区平片显示有肥皂泡样钙化病变的病例。患者为一名30岁男性,自幼出现全身性惊厥发作。CT扫描显示这些病变边缘密度高,中心密度相对较低。最近,日本报告了一些宫崎并殖吸虫脑受累病例。免疫血清学检测对并殖吸虫病的诊断最有用。硫双二氯酚给药是急性期的首选治疗方法。脑症状出现两年后血清学检测呈阳性的钙化病变,如有可能应手术切除。