皮下イヌ糸状虫症の1例 [in Japanese] A CASE OF HUMAN SUBCUTANEOUS DIROFILARIASIS [in Japanese]
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ヒトイヌ糸状虫症の1例を経験したので報告する.症例は, 44歳,男性.左前胸部に可動性良好,弾性硬な腫瘤を認め,局所麻酔下に摘出した.組織学的に変性した線虫の断端と異物肉芽を認めた.虫体断端の計測値は, 87.5×295μmから143×345μmであった.角皮は厚く15～20μmで, 3～4層からなり,外縦走隆起を認めない.側索部には内縦走隆起を認めた.虫体は変性が激しいため,角皮下層,筋層,消化管や生殖器は分別ができなかった.虫体の寄生部位,形態学的特徴,計測値から,イヌ糸状虫の幼若虫と判定した.本症例はわが国における皮下組織寄生のヒトイヌ糸状虫症の14例目である.
A 44-year-old man was admitted because of a mass on his left anterior chest wall. Palpation of the mass revealed a smooth, elastic-hard nodule measuring 1.5cm in diameter that was not fixed to the skin or underlying tissue and could be moved readily. Tumor excision was performed under local anesthesia. Histological examination revealed a foreign body granuloma with some degenerated nematode parasites. The worms measured 87.5×295μm-143×345μm in diameter, and had a 15-20μm thick cuticle with 3-4 distinct layers without external longitudinal ridges. They had well-developed lateral chords with distinct internal longitudinal ridges. The hypodermis, muscle layer, digestive tract, and reproductive organs of the worms could not be differentiated due to severe degenerative changes. The worms were thus diagnosed as immature <i>Dirofilaria immitis</i> based on their morphological features, size, and the site of parasite infection. This is the fourteenth human subcutaneous dirofilariasis case, and is the first case of extra-pulmonary dirofilariasis reported in Akita prefecture.
- Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 59(11), 2955-2958, 1998-11-25
Japan Surgical Association