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Pulmonary dirofilariasis, a rare lung infection caused by a dog heartworm, can mimic lung nodules on CT scans. Surgical resection confirmed the diagnosis in a 70-year-old man, highlighting the importance of considering parasitic causes.

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Area of Science:

  • Medical Parasitology
  • Thoracic Surgery
  • Diagnostic Imaging

Background:

  • Pulmonary nodules are common incidental findings on chest imaging, often raising concerns for malignancy.
  • Dirofilariasis, a parasitic zoonosis caused by Dirofilaria species, is typically transmitted by mosquitoes and affects various animal hosts.
  • Pulmonary dirofilariasis in humans is an uncommon manifestation, often presenting as a solitary pulmonary nodule.

Observation:

  • A 70-year-old male patient presented with a 15 mm pulmonary nodule in the left lower lobe identified via chest computed tomography (CT).
  • The nodule's appearance on CT raised suspicion for a malignant lung tumor, necessitating further investigation.
  • Surgical intervention, specifically a partial lung resection, was performed due to the indeterminate nature of the lesion.

Findings:

  • Intraoperative pathological examination revealed characteristic coagulation necrosis within the resected lung tissue.
  • The final pathological diagnosis confirmed the lesion as pulmonary dirofilariasis, a parasitic lung infection.
  • The patient's pulmonary nodule was definitively identified as a non-malignant parasitic granuloma.

Implications:

  • This case underscores the importance of including parasitic infections, such as pulmonary dirofilariasis, in the differential diagnosis of solitary pulmonary nodules.
  • Accurate diagnosis of pulmonary dirofilariasis can prevent unnecessary aggressive treatments for presumed lung cancer.
  • Increased awareness among clinicians regarding zoonotic parasitic diseases is crucial for timely and appropriate patient management.