Bečejac Tomislav, Marcelić Luka, Danolić Damir, Vrančić Marko, Hiršl Dorian, Jalšovec Dubravko
Clinical Department of Thoracic Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
Department of Gynecologic Oncology, University Hospital for Tumors, University Hospital Centre Sestre milosrdnice, Zagreb, Croatia.
Wien Med Wochenschr. 2025 Apr;175(5-6):135-139. doi: 10.1007/s10354-024-01044-w. Epub 2024 Jun 5.
Clinicians face significant diagnostic challenges when dealing with nodal lesions of the lung. The majority of lung nodules are benign; however, a significant number can be cancerous. Dirofilaria infestation should also be considered in the differential diagnosis of nodal lung lesions. Most patients with Dirofilaria infestation are asymptomatic. To determine the etiology of nodal lung infiltrations, procedures like radiological imaging, bronchoscopy, endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA), transthoracic biopsy (TTB), tumor markers, nonspecific serological tests, or surgical removal of the lung coin lesions can be performed. Coil marking of the smaller lung lesions under computed tomography (CT) guidance is a helpful tool in determining the position and localization of the nodal lung lesions. Video-assisted thoracoscopic surgery (VATS) or robot-assisted thoracoscopic surgery (RATS) wedge resection is a diagnostic and therapeutic method of choice. No additional treatment of Dirofilaria other than wedge resection of the lung is necessary.
临床医生在处理肺部结节性病变时面临重大的诊断挑战。大多数肺结节是良性的;然而,相当一部分可能是癌性的。在肺部结节性病变的鉴别诊断中也应考虑犬恶丝虫感染。大多数犬恶丝虫感染患者无症状。为了确定肺部结节性浸润的病因,可以进行放射影像学、支气管镜检查、支气管内超声引导下经支气管针吸活检(EBUS-TBNA)、经胸壁活检(TTB)、肿瘤标志物、非特异性血清学检测或手术切除肺部钱币状病变等检查。在计算机断层扫描(CT)引导下对较小的肺部病变进行线圈标记是确定肺部结节性病变位置和定位的有用工具。电视辅助胸腔镜手术(VATS)或机器人辅助胸腔镜手术(RATS)楔形切除术是诊断和治疗的首选方法。除了肺部楔形切除术外,无需对犬恶丝虫进行其他治疗。