A Case Report Of Bronchial Sparganosis Mansoni And Literature Review

Objective Sparganosis mansoni is a parasitic disease, always appears in the eye, subcutaneous tissue, oral cavity and maxillofacial region, et al, but seldom in the lung and bronchus. This article was to improve the recognization of clinical characteristics for bronchial sparganosis mansoni.Method Retrospectively review of a case of bronchial sparganosis mansoni in the first affiliated hospital of Guangxi Medical University in2011, analyze its symptoms, physical examinations, laboratory tests, imaging findings and pathological charasterization.Result (1) The patient was an elderly man, he had a history of ingesting raw frog, snake, fish, shrimp, sheep, pork, et al, and drinking raw sheep blood, snake blood and stream water.(2) Clinical manifestations:the patient’s syndrome was cough, sputum and hemoptysis.(3) His leukocyte and eosinophil counts were normal, Stool examination for parasite eggs was negative, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were elevated.(4)The chest High resolution computed tomography(HRCT) features: there was a single mass with ill-defined border, lobulation, spinous protuberance and heterogeneous enhancement in the right lung hilar. Its size was about22mm X18mm, The corresponding bronchus was narrow, there were many enlarged lymph nodes with calcification in the lung hilar and mediastinal reveal.(5) Pathology:transbronchial lung biopsy specimen showed numerous lymphocytes and mononuclear leucocytes infiltrating bronchial mucosa, there were also some eosinophilic cells and granulomas. There were some bronchial mucosa epithelial squamous metaplasia especially moderate-severe hyperplasia and some heteromorphous glands, which was suspected adenocarcinoma. Bronchial mucosa stain was positive by congo-red stain.(6) Parasite examination:a thread-like worm was found in right lower lobe inside the base period by bronchoscopy, which was identified as plerocercoid tapeworm larva(sparganum) of spirometra mansoni by Guangxi Medical University parasite laboratory.(7) After taking praziquantel, The patient’s symptoms were obviously improved. He was still in the follow-up.Conclusions (1) Bronchial sparganosis mansoni has not been reported, Someone who had used intermediate host as a poultice to a wound, drinked untreated water containing infected copepods and ingested raw or inadequately cooked flesh of snakes, birds or frogs infected with the sparganum, should be alerted to sparganosis mansoni.(2) Bronchial sparganosis mansoni gets insidious onsets, the radiological feature was similar to the imaging of lung cancer. Sparganum settling and migrating in the lung and bronchus may cause glands abnormal hyperplasia and (or) bronchial mucosal amyloidosis, therefor we should actively achieve mass pathology for the patient.