Human Pulmonary Dirofilariasis. Report of Six Cases.

  • Hiroshima Kenzo
    Division of Pathology, Institute of Pulmonary Cancer Research, School of Medicine, Chiba University
  • Iyoda Akira
    Division of Pathology, Institute of Pulmonary Cancer Research, School of Medicine, Chiba University
  • Toyozaki Tetsuya
    Division of Pathology, Institute of Pulmonary Cancer Research, School of Medicine, Chiba University
  • Fujisawa Takehiko
    Division of Surgery, Institute of Pulmonary Cancer Research, School of Medicine, Chiba University
  • Aosai Fumie
    Department of Parasitology, School of Medicine, Chiba University
  • Kobayashi Masashi
    Department of Parasitology, School of Medicine, Chiba University
  • Hata Hidekazu
    Department of Parasitology, School of Medicine, Chiba University
  • Yano Akihiko
    Department of Parasitology, School of Medicine, Chiba University
  • Yusa Toshikazu
    Department of Respiratory Surgery, Chiba Rosai Hospital
  • Ohwada Hidemi
    Division of Pathology, Institute of Pulmonary Cancer Research, School of Medicine, Chiba University

抄録

We report six cases of pulmonary dirofilariasis diagnosed at our laboratory with clinical and pathological features. The nodules of dirofilariasis were round in three cases as previously reported, however dumbbell-shaped in two cases. The nodule did not attach to the pleura in four cases. Microscopically, the nodules were granulomas composed of central coagulation necrosis and peripheral fibrosis with round cell infiltration, histiocytes, and multinucleated giant cells. Necrotic pulmonary artery with single or multiple sections of degenerated nematode was observed in the center of the nodule. Dilated bronchioles with inflammation were observed in the nodule in four cases. Collapse of the alveoli, organizing pneumonia, hemosiderin-laden macrophages were observed around the nodule. We suppose that the nodule is not an infarction but a granuloma caused by antigen released from the nematode. Because the pulmonary dirofilariasis is difficult to be differentiated from primary or metastatic lung carcinoma, and the inflammation exists around the nodule, the nodule should be removed surgically.

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