간내 종괴로 발견된 간질증 1례

Abstract

Fascioliasis is a zoonotic helminthiasis caused by Fasciola hepatica, the sheep liver fluke. Humans are accidental hosts in the life cycle of the parasite. They are infected by the ingestion of water or raw aquatic vegetables contaminated with the metacercaria. A 57 year-old Korean housewife, ate raw food for 2 years, suffered from right upper quadrant pain, fever and chill. On the abdominal sonogram 6×3×4 cm ill-defined inhomogenous hypoechoic mass in S8 of the liver and delayed phase of dynamic liver CT scan showed multiple ill-defined hypodense nodular lesions with faint peripheral enhancement. Liver biopsy revealed a granuloma composed of central necrotic lesion containing eosinophils surrounded by histiocytes and fibroblasts. Although the worm was not seen, the histologic finding was consistent with fascioliasis and the serologic test for Fasciola -specific antibody by micro-ELISA was positive. We tried praziquantel(70 mg/kg/day) for 7 days. Six months later, follow up abdominal sonogram showed marked resolution compared with previous film, and Fasciola-specific antibody was negative.