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[Pulmonary dirofilariasis found unexpectedly during thymectomy].

K Makiya¹, M Tsukamoto, H Manabe

¹Department of Medical Zoology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

Journal of UOEH

|September 1, 1988

Summary

A lung nodule in a Japanese woman was found to contain an immature Dirofilaria immitis, commonly known as dog heartworm. This case highlights the increasing prevalence of dirofilariasis in Japan.

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Area of Science:

Veterinary Parasitology
Human Pathology
Medical Entomology

Background:

Myasthenia gravis is an autoimmune disorder affecting neuromuscular junctions.
Mediastinal tumors, particularly thymomas, are associated with myasthenia gravis.
Dirofilariasis, caused by Dirofilaria species, is typically a zoonotic disease affecting canids.

Observation:

A 56-year-old woman diagnosed with mediastinal tumor and myasthenia gravis underwent surgery.
A lung nodule was discovered and biopsied during the operation.
Histological examination revealed a granulomatous nodule containing a degenerated segmented worm.

Findings:

The worm's cross-section (400 x 310 microns) displayed a 3-layered tegument, internal cuticular ridges, high lateral chords, and polymyarian muscles.

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These morphological characteristics led to the identification of the parasite as an immature Dirofilaria immitis.

The case is discussed in the context of a recent increase in dirofilariasis cases in Japan.

Implications:

This case suggests potential for Dirofilaria immitis to cause pulmonary lesions in humans beyond typical zoonotic presentations.
Increased surveillance and diagnostic awareness for dirofilariasis in human populations may be warranted in endemic areas.
Understanding the transmission dynamics and clinical manifestations of dirofilariasis is crucial for public health in Japan.