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Human Pulmonary Dirofilariasis Coexisting with Lung Cancer

肺癌病患合併人體肺部犬心絲蟲症-病例報告

摘要


犬心絲蟲症乃流浪狗之中常見之寄生蟲感染。在極罕見之情況下,蟲體可藉由中間宿主-蚊子,在人體肺部形成病灶。影像學上,典型的病灶為邊緣完整,位於周邊之孤立性結節,常與肺部癌症造成混淆。必須依賴手術切除後,顯微鏡下看見部分蟲體的病理發現才能診斷。在本文中,我們報告一位48歲女性在診斷肺癌的同時,意外發現肺部犬心絲蟲病灶。臨床上若在肺癌病患見到腫瘤以外之肺部結節,應考慮腫瘤肺部轉移以外之診斷。若病患可接受手術切除,術前無法診斷之肺部結節應考慮切除以達成適當之診斷。

並列摘要


Dirofilariasis is a common parasite infection in stray dogs caused by Dirofilaria immitis (dog heartworm). Under very rare circumstances, it can cause human pulmonary lesion via a vector/intermediate host, the mosquito. It typically presents as a well-circumscribed, peripheral, solitary pulmonary nodule on radiograph, and is easily confused with lung malignancy. Diagnosis rests on histopathologic identification of the excised worm. We reported a 48-year-old female with a rare coexistence of pulmonary dirofilariasis and lung cancer. Clinical suspicion of a mixed etiology should be maintained in a lung cancer patient with a separate lung nodule. An undetermined pulmonary nodule should not preclude the possibility of surgical intervention for lung cancer patients with resectable disease.

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