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Two Cases of Eosinophilic Granulomas Formed in the Large Omentum and Mesentery by the Penetrated ANISAKIS Larva through the Gastrointestinal Tract H. Yoshimura 1 , K. Kondo 1 , N. Akao 1 , Y. Ohnishi 1 , K. Watanabe 2 , B. Shinno 3 , K. Aikawa 4 1Department of Parasitology, School of Medicine, Kanazawa University 2Department of Pathology, National Kanazawa Hospital 3Shinno Surgical Hospital 4Department of Surgery, Kanazawa Seirei Hospital pp.519-522
Published Date 1979/4/25
DOI https://doi.org/10.11477/mf.1403107661
  • Abstract
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 Clinicopathological investigations have been carried out on 71 cases of anisakiasis since the past three years from February 1975, as shown in Tables 1 and 2.

 The present paper deals with two uncommon cases showing granulomatous tumors in the peritoneal tissues due to the penetration of Anisakis larva, coming out from the gastrointestinal lumen.

 Case 1. A man aged 22 years. On the day before violent epigastralgia with tarry or bloody stool, the patient ate raw sea fish such as mackerel and cod. The abdominal symptoms markedly developed day after day. The surgical operation was done on the 9 th day from the onset. At laporatomy, a tumor of the size of a walnut was found on the large omentum near the large curvature of the stomach (Fig. 1). The tumor, measuring 2.2×1.3×1.6 cm, appeared to be the metastatic focus of the malignant neoplasm. On the cutting surface of the tumor, a somewhat disintegrated nematode larva was seen as in Figure 2. Histopathologically the eosinophilic granulation accompanied with marked edema and proliferation of the fibroblasts was seen surrounding the transverse section of Anisakis larva (Fig. 3). Latex agglutination was strongly positive and the precipitin bands by agar-gel diffusion (Ouchterlony) was also proved for Anisakis larvae antigen.

 Case 2. A man aged 36 years complained of abdominal pain and tarry stool for 5 days after eating raw mackerel and tunny. The severe abdominal symptoms thereafter developed due to the repeated dishes of raw fish about 10 days from the occurrence of the sickness. At laporatomy, the terminal ileum was dark-red and markedly thickened (Fig. 4). The mesentery near the focus of the ileum was also dark-red and showed diffuse thickening such as the presumable tumor (Fig. 5). Histopathological findings of the foci of the ileum and mesentery involved were almost the same as those of case 1. Although no Anisakis larva was recognized in the eosinophilic phlegmon of the mesentery, the granulation was suspected to have possibly occurred by the invasion of the Anisakis larva. The positive reactions by Latex agglutination and precipitin test (Ouchterlony) would also support the evidence of extra-gastrointestinal Anisakis infestation.


Copyright © 1979, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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