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Weekly Chest CasesArchive of Old Cases

Case No : 768 Date 2012-07-17

  • Courtesy of Jeong Min Ko / St. Vincent
  • Age/Sex 22 / F
  • Chief Complaintabdominal discomfort
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Figure 1

Diagnosis With Brief Discussion

Diagnosis
Hydatid disease
Radiologic Findings
Chest PA shows a few large pleural based soft tissue density masses in the left hemithorax. On contrast-enhanced CT scan, there are several multiloculated cystic masses along pleura and peritoneal cavity. Note that internal air density within a pleural cyst of left lower hemithorax.
Brief Review
Hydatid disease is a worldwide zoonosis produced by the larval stage of the Echinococcus tapeworm. Once the parasite passes through the intestinal wall to reach the portal venous system or lymphatic system, the liver acts as the first line of defense and is therefore the most frequently involved organ. Hydatid disease primarily affects the liver and typically demonstrates characteristic imaging findings. However, there are many potential local complications (eg, intrahepatic complications, exophytic growth, transdiaphragmatic thoracic involvement, perforation into hollow viscera, peritoneal seeding, biliary communication, portal vein involvement, abdominal wall invasion).
In humans, hydatid disease involves the liver in approximately 75% of cases, the lung in 15%, and other anatomic locations in 10%. Intrathoracic extrapulmonary hydatid disease constitutes 2.3% - 7.4% of all hydatid diseases. Among intrathoracic extrapulmonary hydatid cysts, 55% of the cysts are located in the fissure, 18% within the parietal pleura, 14% in the chest wall, 4.5% in the mediastinum, and 4.5% in the diaphragm. Pleural hydatid cysts can develop chiefly as a result of liver or lung cyst rupture into the pleural space with complications of pneumothorax, pleural effusion or empyema.
(See case 339)
References
1. Pedrosa I, Sa챠z A, Arrazola J, Ferreir처s J, Pedrosa CS. Hydatid disease: radiologic and pathologic features and complications. Radiographics. 2000;20:795-817.
2. Shrinivasan B, Mohite PN, Thingnam SK. Extrapulmonary intrapleural hydatid cysts
Keywords
pleura, infection, parasitic,

No. of Applicants : 79

▶ Correct Answer : 34/79,  43.0%
  • - aarthi scans , India salome rajesh
  • - Goa Medical College , India Paresh Desai
  • - Kyung Hee Universitiy Hospital at Gangdong , Korea (South) Seong Jong Yun
  • - Universidad del Desarrollo- Clinica Alemana , Chile Patricio Maximiliano Latorre Brajovic
  • - radiologist, aditya imaging centre , India vivek patel
  • - Diskapi Yildirim Beyazit Hospital, Ankara , Turkey Meric Tuzun
  • - CHU Poitiers , France CHAN paul
  • - Kurashiki Seijin-byo Center , Japan Akihiro Tada
  • - mmcri , India sangeetha srinivasan
  • - Kaohsiung Veteren , Taiwan Ying-kai Huang
  • - Ondokuz Mayis University , Turkey Cetin Celenk
  • - University of British Columbia , Canada Amr Ajlan
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - UWO , Canada S Lee
  • - All India Institute of medical sciences , India Justin Moses
  • - Vikram hospital , India Pravin Mahadevappa
  • - Dr.Rajendra Prasad Government Medical College - Tanda, (Himachal Pradesh) , India Narvir Chauhan
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Travancore Medical College , India Chary D
  • - HIA Legouest - METZ , France Alban Gervaise
  • - HUEC , Brazil Diogo Pinheiro
  • - Deptt of Radiodiagnosis & Imaging, PGIMER chandigarh , India Ram Galwa
  • - Asan Medical Center , Korea (South) Hye Jeon Hwang
  • - Himeji St.Mary Hospital , Japan Yuichiro Kanie
  • - CAC Rennes , France nicolas gautier
  • - Private sector , Greece Vasilios Tzilas
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - IRSA La Rochelle France , France Denis Chabassiere
  • - Homs National Hospital , Syria Rami Abou Zalaf
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Zaid Alsheriti hospital- Alsweida , Syria jehad alakabani
  • - CHRU lille , France manuel toledano
  • - Radnet Teleradiology Istanbul , Turkey Armagan Sarac
  • - NDMVP Nashik , India Imran Jindani
▶ Correct Answer as Differential Diagnosis : 14/79,  17.7%
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - Medical College Chest Hospital,Thrissur,Kerala , India Raveendran TK
  • - McGill University Health Center , Canada Alexandre Semionov
  • - Kyunghee University Hospital at Gangdong , Korea (South) Woo Jin Yang
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - XiangYa hospital , China Xia Yu
  • - China Medical University , Chia-Yi Christian Hospital ,Taiwan, R.O.C. , Taiwan Jun Jun Yeh
  • - Hanyang University Hospital , Korea (South) Yo Won Choi
  • - Toyama University Hospital, Laboratory of Pathology , Japan TOMONORI TANAKA
  • - Centre Hospitalier Lyon Sud , France matthieu ROUSSET
  • - Hanyang university medical center , Korea (South) YOONAH SONG
  • - IRSA , France, Metropolitan BIGOT
  • - clinique de SAVOIE , France, Metropolitan gay-depassier philippe
  • - Kyung Hee University Medical center , Korea (South) Myung You
▶ Semi-Correct Answer : 4/79,  5.1%
  • - Hanam sungshim hospital , Korea (South) CHANG IL KIM
  • - Kyungpook National University Hospital , Korea (South) Jaekwang Lim
  • - ASAN MEDICAL CENTER , Korea (South) CHONG HYUN SUH
  • - Asan medical center , Korea (South) Sang Young Oh
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