Primary hydatid cyst of the breast: A case report

We describe herein the rare case of a hydatid cyst found in the breast of a 26-year-old woman. Clinically, the mass was at first suspected of being a fibroadenoma, but fine needle aspiration cytology (FNAC) yielded clear fluid only. Histopathologic examination of the resected speciman confirmed that it was a hydatid cyst.     

Intracranial alveolar echinococcosis: CT and MRI

Intracranial alveolar echinococcosis is uncommon. We report a patient with right frontal lobe and palpebral lesions secondary to a primary hepatic focus with secondary lesion in the lung. The intracranial and palpebral cystic masses were totally removed and both proved to be alveolar hydatid cysts. An unusual feature in this case is CT and MRI demonstration of dural and bony extension.     

Orbital hydatid cysts: Report of four cases

Hydatid cysts of central nervous system are rare and comprise only 2% to 3% of all hydatid cysts reported. Orbital localization is very uncommon and has been reported less than 1 % of all hydatid diseases. The primary treatment of hydatid disease is surgical. The most important complication of the surgical treatment is secondary hydatidosis due to spillage of the cyst contents. Because of the difficulties of the orbital localization, total extirpation of the cysts without rupture is almost impossible. Preventing spontaneous rupture of the cysts during surgery and postoperative antihelmintic treatment should be taken into consideration in these cases.This study includes four cases who underwent surgery for orbital hydatid cysts. Radiological characteristics, operative technique and postoperative medical therapy are discussed.     

阿苯达唑脂质体治疗包虫病的初期临床观察

目的：评价阿苯达唑脂质体（L－ABZ）口服液的临床疗效及药物副作用，为该药的临床应用提供依据。方法：选择53例包虫病患者，分为3组：A组为单纯服药组（35例），连续口服L－ABZ 3－6个月；B组为包虫囊肿穿刺前后服药组（4例），穿刺前3－7d开始服药，穿刺后连服1个月；C组为手术前后服药组（14例），术前3－7d开始服药，术后可进食水后即开始服药，疗程1个月。3个治疗组服药剂量均为每天10mg/kg，2次／d。同时动态随访病人服药前后的血常规、肝肾功、胸部X线片、B超或CT以及病人对药物的毒副反应。用治愈率、有效率、部分有效率和无效率来衡量A组的疗效。以复发率（观察至少1年）来判断B、C组的疗效。结果：A组治愈16例（45．7％），有效9例（25．7％），部分有效6例（17．1％），无效4例（11．4％），总有效率88．6％；B组、C组随访时间1－3年，尚无复发。临床药物治疗的53例服药病人中，尚未见因药物的副反应而终止治疗的病例。结论：阿苯达唑脂质体（L－ABZ）口服液对包虫病病人疗效较为肯定，毒副反应轻，患者能够长期服用，尤其适用于某些不宜施行手术治疗或复杂的包虫病例。     

泡型肝包虫病的超声诊断再探讨-附100例分析

目的:探讨泡型肝包虫病的B超特征,提出分型依据。方法:综合分析100例经手术或穿刺病理证实的B超声像图表现,并结合部分经CT、MRI检查病例对比研究。结果:100例泡型肝包虫,B超主要表现为①肝内不规则强回声团块80例,其中团块内呈弥漫性粗颗粒状强回声类似"落雪状"改变25例,团块内合并坏死液化20例,团块内钙化25例,钙化和液化同时出现10例。②肝内呈结节状改变20例。结论:泡型肝包虫病表现有其特征性,团块内粗颗粒状强回声,不规则液化坏死,斑片状钙化,周边无低回声暗晕以及彩超团块内无血流信号是与肝癌等肿块鉴别的重要依据。     

Cellular immunity in experimental Echinococcus multilocularis infection. II. Sequential and comparative phenotypic study of the periparasitic mononuclear cells in resistant and sensitive mice.

Cellular immune responses have been shown to be associated with differential evolutions of E. multilocularis infection in intermediate hosts. A relationship between course of delayed-type hypersensitivity (DTH) against parasitic antigens and receptivity of murine strains has been demonstrated recently. The aim of this study was to correlate resistance and sensitivity to E. multilocularis infection with the phenotypic patterns of cells within the periparasitic granuloma. Evolution of the ratios, macrophages/T lymphocyte and Ly1/Ly2 T lymphocytes, was associated with the receptivity of the strains. Persistence of numerous L3T4 + T lymphocytes and low numbers of macrophages and Ly2 + T lymphocytes were observed in the 'resistant' C57BL.10 mice. Comparison of the results with course of the DTH against E. multilocularis antigens showed that the particular phenotypic pattern observed in resistant mice was associated with a particular profile of DTH after infection. These results and similar observations in human alveolar echinococcosis suggest that cell composition of the periparasitic granuloma might be of crucial importance in controlling the spontaneous development of E. multilocularis larvae in the intermediate host.     

Impeded Th1 CD4 memory T cell generation in chronic-persisting liver infection with Echinococcus multilocularis

Memory T cells of the CD4 lineage coordinate immune responses against pathogens via the antigen-induced secretion of potent effector cytokines. The efficacy of these responses is thought to depend on both the overall number of pathogen-specific memory T cells and the particular array of cytokines that these cells are programmed to secrete. It is unknown to what extent cellular immunity can be induced by Echinococcus multilocularis infection. To examine the immunological memory provided by the adaptive cellular immune system in control of the chronic-persisting infection, peripheral lymphocytes of patients with alveolar echinococcosis (AE) were studied ex vivo. Stimulation of memory cells was performed with E. multilocularis vesicular fluid, purified protein derivative as recall antigen and phytohemagglutinin. Cytomegalovirus latency served as disease control. Frequencies of circulating CD4(+) T cells secreting IFN-gamma, IL-2, tumor necrosis factor-alpha, IL-4, IL-5 and IL-10 were determined by both cytokine flow cytometry and ELISPOT assays. Most strikingly, in chronic AE the frequencies of E. multilocularis antigen-specific cells committed to T(h)1-cytokine production were low (mean 0.5% of CD4(+) T cells). However, an E. multilocularis-specific response of CD4(+) T cells at frequencies of >/=0.1% was detected in the majority of AE patients (68%). Low numbers of cells committed to T(h)1 cytokine secretion were invariably seen in patients with active and inactive disease. Interestingly, the number of specific CD4(+) memory T cells was not increased in cured AE patients after complete surgical removal of the metacestode. Hyporesponsiveness during the chronic helminth infection was E. multilocularis specific. Thus, our results demonstrate that antigen-specific memory function against E. multilocularis is markedly different from that against viral or bacterial pathogens. Whether the antigen-specific cellular hyporesponsiveness with impeded T(h)1 CD4(+) memory T cell generation is a cause or a result of the progressive metacestode activity remains to be determined.     

Continuous long-term albendazole therapy in intraabdominal cystic echinococcosis

Ａｌｂｅｎｄａｚｏｌｅｈａｓｂｅｅｎｗｉｄｅｌｙｕｓｅｄｉｎｔｈｅｔｒｅａｔｍｅｎｔｏｆｃｙｓｔｉｃｅｃｈｉｎｏｃｏｃｃｏｓｉｓ ,ｂｕｔｒｅｌａｔｉｖｅｌｙｆｅｗｌｏｎｇ ｔｅｒｍｆｏｌｌｏｗ ｕｐｒｅｓｕｌｔｓａｒｅａｖａｉｌａｂｌｅｔｏｅｖａｌｕａｔｅｌｏｎｇ ｔｅｒｍｅｆｆｉｃａｃｙａｎｄｓａｆｅｔｙ Ｉｎｔｈｉｓｓｔｕｄｙ ,ｗｅｆｏｌｌｏｗｅｄｕｐ 15ｐａｔｉｅｎｔｓｗｈｏｒｅｃｅｉｖｅｄｃｏｎｔｉｎｕｏｕｓｌｏｎｇ ｔｅｒｍａｌｂｅｎｄａｚｏｌｅｔｈｅｒａｐｙ ;ｃｌｉｎｉｃａｌｔｈｅｒａｐｅ…     

Diagnostic value of two-dimensional echocardiography in cardiac hydatid disease

Echinococcal infection of the heart is rare. The preoperativefindings, with special attention to two-dimensional echocardiography(2DE), of six patients with cardiac echinococcosis and theirsurgical and pathological correlations are reported. Cardiachydatid cysts (HCs) were located in the cardiac apex in threepatients, in the upper part of the interventricular septum extendingtowards the anterior aspect of the heart in one and in the postero-superiorright atrial wall in another patient. The remaining patienthad multiple intrapericardial cysts. In three patients the cystspresented as well defined, rounded, echolucent masses withinthe myocardial wall bulging into the cardiac chambers. In twopatients, the cysts had ruptured into a cardiac chamber withloss of the characteristic ‘cystic’ appearance;these cysts presented as an echogenic or solid mass protrudinginto a cardiac chamber. Finally, another patient had one HCwith echolucent appearance and another HC in a different locationwith echogenic appearance; this last cyst corresponded to adegenerated HC. In two cases the cyst showed a loculated internalaspect. In one patient the myocardial segment involved by thecyst had a dyskinetic movement. In all six patients, 2DE accuratelydemonstrated the location and morphological details of the cardiaccysts, permitted recognition of the ruptured and/or degeneratedcysts and was superior to thoracic computed tomography and angiographyin the preoperative assessment of these patients. Nuclear magneticresonance imaging (one patient) gave no further informationto that obtained by 2DE. We conclude that 2DE is the techniqueof choice for an early diagnosis of this rare entity.