Chest
Clinical InvestigationsPulmonary Dirofilariasis: The Largest Single-Hospital Experience
Section snippets
Case 1
A 48-year-old woman, who is a nonsmoker, was referred to our hospital in August 1989 for evaluation of a 0.8-cm smooth, well-circumscribed, noncalcified nodule in the right middle lobe found on a routine chest x-ray film. The patient was totally free of symptoms.
Case 2
A 67-year-old man, who is a smoker, underwent routine physical examination in August 1989. He had had coronary artery bypass surgery eight years earlier. A chest x-ray film showed a smooth 1-cm noncalcified lesion in the left upper
Discussion
The first report of a human infection from Dirofilaria was in 1887 when de Magalhaes reported finding one male and one female worm in the left ventricle of a male child from Rio de Janeiro, Brazil, as reported by Robinson et al.2 Subsequently in the United States, Dirofilaria was identified in the pulmonary artery in 19403 and in a pulmonary infarction in 1961.4 Since that time, 87 cases from the United States have been recorded in the literature (Fig 1). In no instance have microfilariae been
ACKNOWLEDGMENT
Special acknowledgment is made to Dr. Dina Mody for her help in preparation of the pathology slides, to Dr. Alpert, pathologist, for her help in retrieving cases of dirofilariasis, and to Dr. Thomas Alexander of Tyler, Tex, for graciously supplying the original chest x-ray film for one of our patients, as well as to Natale McDaniels and Magdalena Price from the Pathology Department, and to Barbara Perry for her invaluable secretarial assistance.
Special acknowledgment also is made to the
References (11)
- et al.
Pulmonary dirofilariasis in man: a case report and review of the literature
J Thorac Cardiovasc Surg
(1977) - et al.
Computed tomography of the solitary pulmonary nodule
Semin Roentgenol
(1984) - et al.
Pulmonary dirofilariasis: the great imitator of primary or metastatic lung tumor
Human Pathol
(1989) - et al.
Discovery of human heartworm infection in New Orleans
J Parasitol
(1941) A case of dirofilariasis involving the lung
Am J Trop Med Hyg
(1961)
Cited by (67)
Human Pulmonary Dirofilariasis: A Review for the Clinicians
2022, American Journal of the Medical SciencesPathology of infectious diseases of the lower respiratory system
2020, Diagnostic HistopathologyCitation Excerpt :Parasites, in particular helminths or their products, may produce nodules in the lung. In Dirofilariasis (Dirofilaria immitis – heartworm) the dead nematode embolizes to the lung, causes infarction and incites a localized fibro-inflammatory reaction, producing a coin lesion.17 The eggs of Paragonimus (lung fluke), a trematode acquired through ingestion of undercooked crustaceans and those of schistosomal species, incite a fibro-granulomatous response, often with an eosinophilic component (see below).3,18,19
Pictorial Review of Thoracic Parasitic Diseases: A Radiologic Guide
2020, ChestCitation Excerpt :These lesions may be accompanied by pulmonary infarction and can contain central areas of necrosis. Histopathologic analysis of excised nodules is diagnostic.4,31 In one of the largest case series available in the current literature, the authors described a right lung (75%) and lower lobes (58%) predominance of pulmonary dirofilariasis in 39 patients, with 41 lung lesions, who underwent chest radiographs.32
Pathology of infectious diseases of the lower respiratory system
2017, Diagnostic HistopathologyCitation Excerpt :Parasites, in particular helminths or their products, may produce nodules in the lung. In Dirofilariasis (Dirofilaria immitis – heartworm) the dead nematode embolizes to the lung, causes infarction and incites a localized fibro-inflammatory reaction, producing a coin lesion.17 The eggs of Paragonimus (lung fluke), a trematode acquired through ingestion of undercooked crustaceans and those of schistosomal species, incite a fibro-granulomatous response, often with an eosinophilic component (see below).3,18,19