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Weekly Chest CasesArchive of Old Cases

Case No : 965 Date 2016-04-25

  • Courtesy of Gong Yong Jin / Chonbuk National University Medical School and Hospital
  • Age/Sex 25 / F
  • Chief ComplaintHemoptysis (2 months ago)
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
Pleuropulmonary paragonimiasis
Radiologic Findings
Chest PA view shows bronchial dilatation with small nodules in RLL and LUL. Chest CT shows tubular lucency/bronchiectasis with small nodules in LUL and small subpleural nodule in RLL. Tubular curvilinear lucency in LUL representing the worm burrow tract is shown.
Brief Review
Pleuropulmonary paragonimiasis is a parasitic disease caused by the Paragonimus westermani. This disease is caused by ingestion of a raw or incompletely cooked freshwater crab or crayfish infected with the metacercaria. Pulmonary lesions on chest PA and chest CT varies with the stage of the infection and the surrounding tissue reaction.The initial finding is patchy air-space consolidation due to hemorrhagic pneumonia caused by the migrating worm. At this stage, spontaneous pneumothorax or pleural effusion may be seen. As the juvenile worm matures into adult, cysts may form due to expansion of the small airway by the intraluminal parasite. Worm burrows or migration tracks can be seen a dilated bronchus or tubular lucency. The diagnosis of pleuropulmonary paragonimiasis is made either by detecting eggs in sputum, stool, fluid from bronchoscopic lavage or biopsy specimens, or by a positive anti-paragonimus antibody test. Distinguishing between paragonimiasis and tuberculosis may be difficult.
References
JG Im et al. Pleuropulmonary paragonimiasis: radiologic findings in 71 patients. AJR 1992;159:39-43
Keywords
Lung, Infection, Parasitic infection,

No. of Applicants : 112

▶ Correct Answer : 72/112,  64.3%
  • - Ishikawa Matto Central Hospital , Japan Manabu Akimoto
  • - SAISEIKAI KURIHASHI HOSPITAL , Japan YASUO OOKUBO
  • - Saitama-Sekishinkai Hosptal , Japan Mihoko Yamazaki
  • - Ostu Municipal Hospital , Japan Noriatsu Ichiba
  • - Northern Yokohama Showa university , Japan Kota Watanabe
  • - Osaka Rosai Hospital , Japan Hiromitsu Sumikawa
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Niigata University , Japan Atsushi Uehara
  • - Ulsan University Hospital , Korea (South) Soyeoun Lim
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - The University of Tokyo Hospital , Japan Akifumi Hagiwara
  • - , Korea (South)
  • - Nihon University Itabashi Hospital , Japan Yusuke Watanabe
  • - Kyungpook national university , Korea (South) Chungeun Lim
  • - pusan national university hospital , Korea (South) nam soo won
  • - DELTA CARE HOSPITAL, THANJAVUR, INDIA , India SIVARAJA SUBRAMANIAM
  • - NEUROCITI DIAGNOSTICS , India Justin Moses
  • - Asan Medical Center , Korea (South) Hyung Jung Koo
  • - Seoul National University Bundang Hospital , Korea (South) Ji Eun Park
  • - Pusan national university hospital , Korea (South) MIRI JEONG
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - The Jikei university , Japan Taku Gomi
  • - university of montreal , Canada Andrei Gorgos I
  • - Pusan national university hospital , Korea (South) SeungHyun Lee
  • - , Korea (South) BAEK YOOLIM
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - University of California, San Francisco , United States Travis Henry
  • - The University of Tokyo Hospital , Japan Toshihiro Furuta
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - 異⑸ , Korea (South) Junghwan Kim
  • - Chonnam National University Hospital , Korea (South) So yeon Ki
  • - pusan national university hospital , Korea (South) kim jeongmyeong
  • - Chungbuk national university , Korea (South) Yong Kim
  • - Seoul National University Hospital , Korea (South) Kyu Sung Choi
  • - Medicheck health care , Korea (South) Chae Lim
  • - Kyung Hee University Hospital at Gangdong , Korea (South) Han Na Lee
  • - Okayama University Hospital , Japan Toshiyuki Komaki
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Pusan national university hospital , Korea (South) Minkyu Kwak
  • - University of Tsukuba, Dept of Radiology , Japan Manabu Minami
  • - Kyungpook national university hospital, Korea , Korea (South) SUNGJUN MOON
  • - Ajou university hospital , Korea (South) Hye Lin Kim
  • - Seoul National University Bundang Hospital , Korea (South) Jee Hye Hur
  • - Chungbuk national university hospital , Korea (South) Miran Yeon
  • - Seoul national university hospital , Korea (South) Kumju Chae
  • - Asan Medical Center , Korea (South) Chan Ho Park
  • - Himeji Redcross Hospital , Japan Soichiro Okamoto
  • - Yonsei University Severance Hospital , Korea (South) HYUNSIK JANG
  • - Kanto Rosai Hospital , Japan Taku Tajima
  • - Pusan National University Hospital , Korea (South) JeongBin Park
  • - Military service , Korea (South) Dongryul Jang
  • - Daejin Medical Center Bundang Jesaeng General Hospital , Korea (South) Donghwan Kim
  • - Centre Imagerie de Fribourg , Switzerland Benoit RIZK
  • - MBAL BURGAS , Bulgaria VLADISLAV RUSINOV
  • - Maternity & child hospital , Saudi Arabia Sania ALBlushi
  • - Ajou University Hospital , Korea (South) Seulgi You
  • - Fortis hospital , Mohali , India Shaleen Rana
  • - Kizawa Memorial Hospital , Japan Shoji Okuda
  • - University of Tsukuba Hospital , Japan Sodai Hoshiai
  • - The University of Tokyo Hospital , Japan Kaoru Sumida
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - Jangsung public clinic , Korea (South) Yongsub Song
  • - University of Tsukuba , Japan Toshitaka Ishiguro
  • - Korea University Guro Hospital , Korea (South) Jeong Woo Kim
  • - Private sector , Greece Vasilios Tzilas
  • - Pusan national university hospital , Korea (South) Jin Joo Kim
  • - Kyoto University , Japan Akihiko Sakata
  • - the first affiliatited hospital of nanjing medical univercity , China Hai Xu
  • - stanley medical college , India yazhini v
  • - chungbuk university hospital , Korea (South) Hyeonmi Ryu
  • - Asan medical center , Korea (South) Cherry Kim
  • - Seirei Hamamatsu General Hospital , Japan Kenichi Mizuki
▶ Correct Answer as Differential Diagnosis : 11/112,  9.8%
  • - Nasaret Hospital , Korea (South) Hee Seok Choi
  • - Kashan University of Medical Sciences, kashan , Iran Ebrahim Razi
  • - Dong-nam institute of radiological and medical sciences , Korea (South) Ji-yeon Han
  • - CNUH , Korea (South) Kim Kyun
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - Himeji Red Cross Hospital , Japan Mayu Uka
  • - Samsung Medical Center , Korea (South) Boda Nam
  • - CHU Poitiers , France CHAN paul
  • - GHICL , France manuel toledano
  • - ICD,MCH CALICUT , India rikhy krishnan
  • - Pusan national university hospital , Korea (South) So Park
▶ Semi-Correct Answer : 2/112,  1.8%
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - Ajou university hospital , Korea (South) DONGHYUN LEE
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