Chest
Roentgenogram of the MonthA Solitary Pulmonary Nodule With Zoonotic Implications
Section snippets
Diagnosis: Human pulmonary Dirofilaria immitis
The pathologic findings follow. The nodule was well delineated from the adjacent unremarkable lung and was composed of necrotic tissue with a rim of fibrous tissue and histiocytes. In the center of the necrotic nodule, a remnant of a pulmonary artery, highlighted by elastic stain, contained visible fragments of nonviable roundworm characteristic ofD immitis.
Discussion
D immitis is derived from the Latin words diro and filum, meaning “evil thread.” Dogs, cats, foxes, and other mammals are natural hosts, with the mosquito as the vector-intermediate host, and humans as dead-end hosts. In dogs, mature adult worms shed microfilariae from the right ventricle into the blood stream, which are taken up by the mosquito and transferred to humans during a blood meal in the larval stage. The larvae migrate to the human venous circulation, die in the right ventricle,
Conclusion
Humans with pulmonary dirofilariasis typically are asymptomatic, and the disease is usually discovered as a solitary pulmonary nodule on radiograph. In the absence of commercially available noninvasive testing, diagnosis rests on histopathologic identification of the excised worm. Treatment of this self-limited condition is not required.
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Human Pulmonary Dirofilariasis: A Review for the Clinicians
2022, American Journal of the Medical SciencesCitation Excerpt :Based on the literature, only 116 cases of HPD have been reported in the United States.2 The disease appears to be clustered around the southeastern U.S. along the Atlantic and Gulf coasts, where the canine infestation is also prevalent.13,14 Based on a prevalence analysis, the prevalence of dog heartworm can reach up to 48.9% in the endemic area.15
A 72-year-old woman with previous pulmonary metastasis and new peripheral nodule
2015, ChestCitation Excerpt :The lesions usually measure 1 to 4 cm in diameter.6 There is some controversy about lobe predilection.9 Indeed, some authors have reported (as in our case) a right lower lobe predominance,6,10 whereas Ciferri11 did not find any specific pattern of distribution.
Human pulmonary dirofilariasis coexisting with intercostal neurilemmoma: A case report and literature review
2013, Journal of the Formosan Medical AssociationCitation Excerpt :They will mature sexually and repeat the cycle later in the right ventricle of the final host.1,3,8,9 Cats, foxes, and other mammals can also be hosts.6 A human host is a “dead end” host as the larvae cannot develop to a sexually mature form.
Inflammatory myofibroblastic tumor of the lung with unique histological pattern and association with Sjögren's disease and systemic lupus erythematosus
2011, Experimental and Molecular PathologyCitation Excerpt :In the southwestern part of the United States solitary granulomas are typically caused by Coccidioides immitis, in the upper Mississippi region by Histoplasma capsulatum, less commonly by Cryptococcus or blastomycosis. Rare causes of solitary pulmonary nodule may include a parasitic infection, most commonly a helminthic infection caused by the animal filarial parasite Dirofilaria, the intestinal ascarid, Toxocara, Ascaris or the human filarial parasite (Bielawski et al., 2001; Travis et al., 2002; Martínez et al., 2005; Sakai et al., 2006). These infections are prevalent in certain tropical and subtropical regions of the world.
A case of human pulmonary dirofilariasis
2008, International Journal of Infectious DiseasesChapter 4 Heartworm Disease in Animals and Humans
2008, Advances in ParasitologyCitation Excerpt :Radiological characteristics of the coin lesion show a solitary pulmonary nodule that has well-defined and smooth edges, is spherical or oval in shape and is homogeneously dense (Muro and Cordero, 2001). Most cases are asymptomatic at the time lesions are observed (Bielawski et al., 2001; Milanez de Campos et al., 1997; Stephen, 2001). However, in a recent review, Theis (2005) reported that patients may present coughing or some symptom of pneumonitis prior to diagnosis.