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Recurrent Hepatic Alveolar Echinococcosis: Report of The First Case in Korea with Unproven Infection Route

Korean Journal of Parasitology 2011년 49권 4호 p.413 ~ 418
 ( Kim Su-Jin ) - Dong-A University College of Medicine Department of Pathology

 ( Kim Jong-Han ) - Dong-A University College of Medicine Department of Internal Medicine
 ( Han Sang-Young ) - Dong-A University College of Medicine Department of Internal Medicine
 ( Kim Young-Hoon ) - Dong-A University College of Medicine Department of Surgery
 ( Cho Jin-Han ) - Dong-A University College of Medicine Department of Radiology
 ( Chai Jong-Yil ) - Seoul National University College of Medicine Department of Parasitology and Tropical Medicine
 ( Jeong Jin-Sook ) - Dong-A University College of Medicine Department of Pathology

Abstract


Human alveolar echinococcosis (AE), a hepatic disorder that resembles liver cancer, is a highly aggressive and lethal zoonotic infection caused by the larval stage of the fox tapeworm, Echinococcus multilocularis. E. multilocularis is widely distributed in the northern hemisphere; the disease-endemic area stretches from north America through Europe to central and east Asia, including northern parts of Japan, but it has not been reported in Korea. Herein, we represent a first case of AE in Korea. A 41-year-old woman was found to have a large liver mass on routine medical examination. The excised mass showed multinodular, necrotic, and spongiform appearance with small irregular pseudocystic spaces. Microscopically, the mass was composed of chronic granulomatous inflammation with extensive coagulation necrosis and parasite-like structure, which was revealed as parasitic vesicles and laminated layer delineated by periodic acid-Schiff (PAS) stain. Clinical and histologic features were consistent with AE. After 8 years, a new liver mass and multiple metastatic pulmonary nodules were found and the recurred mass showed similar histologic features to the initial mass. She had never visited endemic areas of AE, and thus the exact infection route is unclear.

키워드

Echinococcus multilocularis; alveolar echinococcosis; hepatic; human
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