頁籤選單縮合
題 名 | Pulmonary Hydatid Cyst--A Case Report and Review of the Literature=肺囊包蟲病--病例報告及文獻回顧 |
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作 者 | 謝義山; 張藏能; 黃克明; | 書刊名 | 胸腔醫學 |
卷 期 | 19:1 2004.02[民93.02] |
頁 次 | 頁66-74 |
分類號 | 415.194 |
關鍵詞 | 肺囊包蟲病; Pulmonary hydatid cyst; |
語 文 | 英文(English) |
中文摘要 | 囊包蟲病是一種囊包蟲感染引起的寄生蟲病,盛行於畜牧發達的國家如澳洲、紐西蘭、南非、環池中海地區的歐洲、亞洲及非洲的國家,臺灣並不是盛行的地區,歷年來也只有兩例病例報告。隨著旅遊及移民率增加,可以預期類似病例會有增加的趨勢。對於胸腔內囊狀病灶,超音波或電腦斷層導引細針抽吸,是診斷及治療的方法,但對於懷疑有囊包蟲病的病人,可能會造成寄生蟲散佈及嚴重的過敏反應,必須避免以細針抽吸來診斷。 我們在這裡提出一個病例報告,這是一位28歲男性,多年前移民到阿根廷。例行健康檢查胸部X光發現兩側肺下側有圓形陰影。胸部電腦斷層及正子攝影檢查顯示為兩側良性肺水囊。由他居住的地區我們高度懷疑是肺囊包蟲病,因此我們建議病人手術切除此病灶。但他到另一醫學中心尋求第二意見,在那裡為他施行超音波導引細針抽吸,引起過敏反應。經由抗寄生蟲藥物治療,他的狀況逐漸改善。四個月後病人發生一次劇烈咳嗽,咳出白色膜狀物,病理檢驗證實為囊包蟲包囊。一年後追蹤,發現兩側病灶都消失。並沒有接受任何手術治療。 |
英文摘要 | The hydatid cyst is a parasitic disease caused by the Echinococcus species, and is prevalent in countries with grazing land, such as Australia, New Zealand, South Africa, South America, the Mediterranean countries of Europe, Asia, and Africa, but is very rare in Taiwan. Only two patients diagnosed with this disease have been reported in Taiwan; this is the third case. With the increasing frequency of travel and immigration, we can expect that there will be more and more patients with this disease in Taiwan. For pulmonary cystic diseases, needle aspiration is a reasonable method of diagnosis and treatment, but is not suitable for patients with a hydatid cyst, since it may cause a disastrous anaphylactic reaction. Proper diagnostic procedures without the use of needle aspiration must be considered. Herein, we report a 28-year-old male who had immigrated to Argentina many years before. At a routine health examination, two round, well-defined mass lesions in the bilateral lower lung fields were disclosed by chest X-ray. The computed tomogram of the chest and a positron emission tomogram both disclosed two benign pulmonary cysts. Hydatid cysts were highly suspected due to his living in an endemic area, and surgical intervention by means of enucleation was suggested. He then went to another medical center for a second opinion. Unfortunately, needle aspiration was performed for diagnosis and an iatrogenic anaphylactic reaction occurred. Under intensive medical treatment with anti-parasitic drugs such as albendazole and praziquantel, his condition improved gradually. Four months later, an episode of coughing up whitish membrane-like material occurred, and the pathologic examination confirmed the diagnosis of a hydatid cystic membrane. He was well after 1 year of follow-up, with a near complete remission of the bilateral lung cysts, and no surgical intervention was performed. |
本系統中英文摘要資訊取自各篇刊載內容。