Nihat AKBAYIR, Nilgün DEMİRBAĞ, Levent ERDEM, Kadir ERGEN, Murat ULUSOY, Mehmet KENDİR

Perkütan karaciğer biyopsisi ile tanısı konulan multiorgan tutulumlu alveolar hidatik hastalığı olgusu

Eozinofili, poliklonal gamma globulin artışı, karaciğerin büyük bir bölümünü kaplayan, sağ sürrenal bez ve sağ böbreğe lokal invazyon gösteren bir kitle ve her iki akciğerde metastatik lezyonlarla başvuran 51 yaşında bir erkek hasta sunulmaktadır. Ağrı'dan gelen hastada alveolar hidatik kist tanısı, tomografide karaciğerdeki kitlede karakteristik kalsifikasyonlar ve pozitif serolojik bulgular eşliğinde perkütan karaciğer iğne biyopsisiyle histopatolojik olarak kesinleştirilmiştir. Bu olgu sunumuyla, gerek klinik ve gerekse de radyolojik olarak hepatosellüler karsinomla karışabilecek alveolar hidatik kist hastalığının, intrahepatik solid kitlelerin ayırıcı tanısında düşünülmesi gerektiği vurgulanmıştır. Bu ayrım, sözkonusu parazitin Türkiye'nin Doğu ve Kuzeydoğu Anadolu Bölgesi'nde endemik olarak görüldüğüne ilişkin veriler ışığında daha da önem kazanmaktadır.

Anahtar Kelimeler:

Echinococcus multilocularis, multiorgan tutulum, karaciğer biyopsisi

A case of alveolar hydatid disease with multiorgan involvement diagnosed by percutaneous liver biopsy

We report a 51-year-old male patient from the city of Ağr› presenting with eosinophilia, increased polyclonal gamma globulin levels, a mass involving most of the liver and with local invasion of right adrenal gland and right kidney, and metastatic lesions in both lungs. The diagnosis of alveolar hydatid disease, associated with a mass in the liver with characteristic calcifications demonstrated by CT, was confirmed by the histopathological examination of the percutaneous liver biopsy specimen and by positive serological findings. With this case report, we emphasize that alveolar hydatid disease of the liver, which may be confused with hepatocellular carcinoma in clinical and radiological aspects, must be kept in mind in the differential diagnosis of intrahepatic solid lesions. This distinction has gained further importance in the light of data indicating that this infestation is encountered endemically in the regions of east and northeast Anatolia in Turkey

Keywords:

Echinococcus multilocularis, multiorgan involvement, liver biopsy,

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