1例潜伏感染25年肝细粒棘球蚴病报告  

A case report of hepatic cystic echinococcosis with a latent infection period of 25 years

作　　者：孙莉[1] 卢恩昌[1] 程猛 艾艳红 SUN Li;LU Enchang;CHENG Meng;AI Yanhong(Medical College,Xiangyang Polytechnic,Xiangyang 441021,China;Xiangyang Center for Disease Prevention and Control,Xiangyang 441021,China;Laboratory Department,Xiangyang Hospital of Traditional Chinese Medicine,Xiangyang 441000,China)

机构地区：[1]襄阳职业技术学院医学院,湖北襄阳441021 [2]襄阳市疾病预防控制中心,湖北襄阳441021 [3]襄阳市中医医院检验科,湖北襄阳441000

出　　处：《中国寄生虫学与寄生虫病杂志》2024年第6期817-819,共3页Chinese Journal of Parasitology and Parasitic Diseases

摘　　要：患者,男,45岁,司机,湖北襄阳人。2023年7月9日以“发现肝脏占位4 d余”就诊于襄阳市中医医院。上腹部MRI检查示:肝右叶巨大囊性T1长/T2稍长占位性病变,DWI呈稍微高信号影像,约139 mm×119 mm×147 mm,病灶内可见多个小囊沿周围呈车轮状排列。采集患者静脉血行免疫血清学检查,结果显示患者棘球绦虫血清IgG抗体阳性。7月15日行肝部分切除术,切除的肿块呈囊性,肉眼观察呈灰白色,体积160 mm×150 mm×150 mm;肿块内容物为淡黄色清亮液体,内见大小不等囊腔。肿块行病理切片,可见囊壁厚约1 mm,有多个原头蚴。患者曾于1996—1999年在西藏服兵役,期间有牛羊粪便接触史、野外饮生水或饮食史。结合患者流行病学调查、临床资料和相关检查结果,最终确诊为西藏输入性肝细粒棘球蚴病,潜伏期长达25年。患者术后恢复较好,1周后出院。出院后嘱患者口服阿苯达唑[15 mg/(kg·d)],术后2周无明显特殊不适。A 45-year-old male patient,a driver from Xiangyang,Hubei,presented to Xiangyang Hospital of Traditional Chinese Medicine on July 9,2023,with a“liver mass detected for more than 4 days”.Upper abdominal MRI revealed a huge cystic lesion in the right lobe of the liver,with T1 long/T2 slightly long signal intensity on MRI.The DWI shows a slightly hyperintense signal,with dimensions of approximately 139 mm×119 mm×147 mm.Multiple small cysts were visible within the lesion,arranged in a wheel-like pattern around the periphery.Immunoserological testing of the patient’s venous blood showed positive IgG antibodies against Echinococcus.On July 15,a partial hepatectomy was performed.The resected mass was cystic,grayish-white and measured 160 mm×150 mm×150 mm in size.The contents of the mass were a pale yellow,clear liquid,with varying-sized cystic cavities inside.Pathological examination of the mass revealed a cyst wall thickness of approximately 1 mm with multiple protoscoleces present.The patient had served in the military in Xizang from 1996 to 1999,during which time he had a history of contact with cattle and sheep feces,as well as a history of drinking unboiled water or consuming food in the wild.Based on the epidemiological investigation,clinical data,and relevant examination results,the patient was ultimately diagnosed with imported hepatic alveolar echinococcosis from Xizang,with an incubation period of up to 25 years.The patient recovered well after surgery and was discharged one week later.Upon discharge,the patient was instructed to take albendazole orally(15 mg/kg per day).Two weeks after surgery,the patient reported no significant discomfort.

关 键 词：肝细粒棘球蚴病 潜伏感染 影像学检查 

分 类 号：R532.32[医药卫生—内科学]