中国寄生虫学与寄生虫病杂志 ›› 2012, Vol. 30 ›› Issue (3): 12-224-227,232.

• 临床研究 • 上一篇    下一篇

10例疑似曼氏裂头蚴病的病原学诊断

曾庆仁1,贺美1,王芳1,张祖萍1 *,粟占三2,周军2,刘保安3,兰智华2,胡勉娟1,蔡力汀1   

  1. 1  中南大学湘雅医学院寄生虫学系,长沙 410013; 2  中南大学湘雅三医院病理科和实验中心,长沙 410013; 3  中南大学湘雅医院病理科,长沙 410078
  • 出版日期:2012-06-30 发布日期:2012-09-28

Pathogen Identification of 10 Suspected Cases  of Sparganosis mansoni

ZENG Qing-ren1,HE Mei1,WANG Fang1,ZHANG Zu-ping1 *,SU Zhan-san2,ZHOU Jun2,LIU Bao-an3,LAN Zhi-hua2,HU Mian-juan1,CAI Li-ting1   

  1. 1  Department of Parasitology,Xiangya School of Medicine,Central South University,Changsha 410013,China; 2  Department of Pathology and Experimental Center of Xiangya Third Hospital,Central South University,Changsha 410013,China; 3  Department of Pathology of Xiangya Hospital,Central South University,Changsha 410078,China
  • Online:2012-06-30 Published:2012-09-28

摘要: 目的  对10例临床疑似曼氏裂头蚴病病例进行病原学诊断。  方法  2009年8月至2011年8月,对4家医院送来的10例患者病理活检标本进行病原学鉴定。10个标本分别来源于腹部皮下包块4例,眼部肿块3例,脑部占位病变、肺部肿块和胸腔积液各1例。3例眼部肿块和1例腹部皮下包块中各取出1条虫体,通过肉眼和显微镜观察虫体解剖组织学特征进行鉴定。余6例标本均采用石蜡包埋、切片及苏木素-伊红(HE)染色后于镜下观察虫体组织,并以曼氏裂头蚴免疫兔血清为一抗通过免疫组化法作进一步鉴定。  结果  自3例眼部肿块中获取的3条完整虫体具典型曼氏裂头蚴形态特征,自腹部皮下包块取出的1条残断虫体在镜下观察到的网状结构和石灰小体均与曼氏裂头蚴解剖组织学特征一致。6个病理切片经HE染色后于镜下观察发现,3个切片呈现典型裂头蚴组织学特征,即体壁有凹凸不等的皱褶,皮层致密较厚呈嗜伊红深染,部分皮层外密布微毛,体内为网状疏松实质结构,可见空泡状石灰小体,但无器官腔和空腔结构;余3个病理切片的虫体组织结构不典型。6个病理切片经免疫组化检测均呈阳性。  结论  该10例临床疑似病例均确诊为曼氏裂头蚴病。

关键词: 曼氏裂头蚴病, 病原学鉴定, 虫体组织学, 免疫组化

Abstract: Objective  To diagnose 10 cases of clinically suspected cases of sparganosis mansoni by pathogen identification.  Methods  In the period from August 2009 to August 2011, 10 biopsy specimens were obtained from 10 patients of four hospitals to identify the pathogen. Among the 10 cases, 4 cases showed abdominal subcutaneous mass, 3 showed eyelid swelling, 1 displayed brain lesions, 1 showed pulmonary mass, and 1 showed pleural effusion. There was one parasite each from three patients with eyelid swelling, and one patient with abdominal subcutaneous mass, which were observed by naked eye and microscope morphologically and histologically. Specimens from other six cases were examined by microscope after paraffin embedding, sectioning, and HE staining. For further identification, the parasite biopsy tissue specimens were detected by immunohistochemistry with Sparganum mansoni-immunized rabbit serum as the primary antibody.  Results  Three intact worms, from three patients with eyelid swelling, showed typical S. mansoni morphological characteristics. One residue parasite from the abdominal subcutaneous mass showed network structures and full of calcareous corpuscles in the body under microscope same as that of S. mansoni. The histological structure in three of the six sections showed typically the body wall with folds, which was dense, thick and deeply eosine stained, part of the tegument outside was covered by micro-hairs. In the worm body there was net-like loose structure and calcareous corpuscles without cavity. The structure of the other three worm sections was atypical. The six worm sections were positive by immunohistochemical detection.  Conclusion  The 10 clinically suspected cases are diagnosed as sparganosis mansoni.

Key words: Sparganosis mansoni, Pathogen identification, Parasite histology, Immunohistochemistry