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Pulmonary dirofilariasis: another coin lesion
Southern Medical Journal
|April 1, 1977
Summary
A rare lung coin lesion in a rheumatoid arthritis patient was caused by a canine parasite, Dirofilaria immitis. This case highlights canine dirofilariasis as a potential diagnosis for lung nodules.
Area of Science:
- Pulmonology
- Parasitology
- Rheumatology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Peripheral coin lesions are common findings in lung imaging.
- Pulmonary manifestations of RA can include nodules.
Observation:
- A 67-year-old woman with a history of RA presented with a peripheral lung coin lesion.
- A wedge resection was performed for diagnosis.
- Pathologic examination revealed a noncaseating granuloma.
Findings:
- The granuloma was identified as being secondary to infection with Dirofilaria immitis, a nematode.
- This represents a rare case of canine dirofilariasis presenting as a pulmonary coin lesion.
- The etiology was linked to the patient's rheumatoid arthritis, though the direct mechanism requires further investigation.
Implications:
- Canine dirofilariasis should be considered in the differential diagnosis of pulmonary coin lesions, especially in endemic areas or with relevant exposure history.
- This case underscores the importance of considering zoonotic parasitic infections in patients with autoimmune diseases.
- Further research may elucidate the interaction between rheumatoid arthritis and parasitic infections in the lung.