A rare case of human pulmonary dirofilariasis with nodules mimicking malignancy: approach to diagnosis and treatment

作者：Ferrari Paolo Albino^*; Grisolia Antonella; Reale Stefano; Liotta Rosa; Mularoni Alessandra; Bertani Alessandro

来源：Journal of Cardiothoracic Surgery, 2018, 13(1): 65.

DOI：10.1186/s13019-018-0750-5

• Pulmonary dirofilariasis
• Video-assisted thoracic surgery
• PCR
• Lung nodules

Background: Human pulmonary dirofilariasis is a rare zoonosis caused by the dog worm Dirofilaria spp., a parasite transmitted by mosquitos and resulting in peripheral lung nodules. The filarial nematode enters the subcutaneous tissue, travels to the right ventricle and dies causing a small pulmonary infarction that may embolize through the pulmonary vessels and may appear as a solitary nodule. These nodules are usually incidentally identified in asymptomatic patients undergoing chest imaging studies, and are generally interpreted to be malignant.
Case presentation: We present the case report of a human dirofilariasis in a patient with multiple pulmonary nodules resected using video-assisted thoracic surgery (VATS). According to our literature review, this is the first case with double synchronous lung nodules reported in Italy.
Conclusions: Minimally invasive resection with histologic examination may be the best approach for the diagnosis and treatment of pulmonary dirofilariasis. Polymerase Chain Reaction testing may provide a more accurate etiological diagnosis in case of an inconclusive pathology result.

• 出版日期2018-6-11