Allergic inflammatory reaction is involved in necrosis of human pulmonary dirofilariasis.

Abstract:

AIMS:To determine whether, in view of the massive inflammatory cell infiltration and the rounded rather than wedge-shaped character of pulmonary lesions in dirofilariasis, the inflammatory response against the worm contributes to the coagulative necrosis, in addition to an ischaemic process. METHODS AND RESULTS:The histopathological features of 13 resected dirofilariasis cases with well-defined nodules ranged from 10 to 30 mm were analysed. On routine histology and using immunohistochemistry, the peripheral encapsulating wall showed mild to severe infiltration of eosinophils, lymphocytes and plasma cells and a histiocytic reaction in all cases, often with necrotic eosinophils seen within the necrosis (84.6%) and inflammatory changes in the adjacent lung (38.5%). The CD4+ lymphocyte count (80.8 +/- 33.4) was greater than that of CD8+ lymphocytes (24.5 +/- 16.9) in the central necrosis and vice versa in the wall. In the necrotic regions, disruption of the pulmonary artery (61.5%) and extravasation of the torn worm (23.1%) could be seen. CONCLUSIONS:These findings indicate that an allergic inflammatory reaction, mediated by eosinophils and lymphocytes, is involved in the formation of the dirofilarial necrotizing granuloma rather than infarction caused simply by embolism.

journal_name

Histopathology

journal_title

Histopathology

authors

Araya J,Kawabata Y,Tomichi N,Kaneko K,Hayashi K,Iwabuchi K,Terasaki Y,Kawashima T,Watanabe M

doi

10.1111/j.1365-2559.2007.02822.x

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

484-90

issue

4

eissn

0309-0167

issn

1365-2559

pii

HIS2822

journal_volume

51

pub_type

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