대한흉부영상의학회 Korean Society of Thoracic Radiology

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대한흉부영상의학회 Weekly Case 검색
대한흉부영상의학회 Weekly Case 검색
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Weekly Chest CasesArchive of Old Cases

Case No : 830 Date 2013-09-23

  • Courtesy of Byoung Je Kim, Byung Hak Rho / Dongsan medical center, Keimyung university
  • Age/Sex 78 / M
  • Chief ComplaintIncidental finding on chest CT scan. Eosinophil 53.7%
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Diagnosis With Brief Discussion

Diagnosis
Toxocariasis
Radiologic Findings
The chest CT scans show multiple ill defined nodules and consolidations with ground glass opacity. These nodules show peripheral and random distribution. The patient had a history of eating raw gall bladder and heart of a dog a week ago. The peripheral blood demonstrated eosinophilia. The test for toxocara canis antibody was positive. After medication of albendazole, multiple nodules are resolved or much decreased.
Brief Review
Toxocariasis혻occurs혻as혻as혻result혻of혻human혻infection혻with혻the혻larvae혻of혻the혻dog혻ascarid.
* Transmission: Individuals who ingest embryonated eggs in the form of contaminated food or more commonly, soil are at risk for developing infection.
* Clinical manifestations: The clinical manifestations of visceral larva migrans are a consequence of both the damage caused by migrating larvae and the host eosinophilic granulomatous response. Migrations of larvae can cause eosinophilic infiltration, granuloma formation, or eosiniphilic abscesses.
* Radiologic findings: Pulmonary visceral larva migrans appear on CT as multifocal subpleural nodules with halo or ground glass opacities and ill defined margins. Either pleural effusion or mediastinal lymphadenopathy is usually not seen.
* Treatment: In general, mild symptoms due to toxocariasis dot not require antihelminthic treatment. Symptoms are usually self-limited and resolve within a few weeks. Eosinophilia may resolve much more slowly over many months, likely due to ongoing angigenic stimulation from dead larvae.
References
Shuji Sakai, et al. Pulmonary lesions associated with visceral larva migrans due to Ascaris suum or Toxocara canis: Imaging of six cases. AJR 2006;186:1697
Keywords
Lung, Eosinophilic lung disease, Parasitic infection,

No. of Applicants : 83

▶ Correct Answer : 10/83,  12.0%
  • - Asan medical center , Korea (South) yoonyoung choi
  • - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
  • - Asan medical center , Korea (South) Sang Young Oh
  • - Kobe City Medical Center General Hospital , Japan Yasuhisa Kurata
  • - AMC , Korea (South) park jong chun
  • - IRSA La Rochelle , France Denis Chabassiere
  • - otsu municipal hospital , Japan kenjirou iwaya
  • - IRCCS Istituto Oncologico - Bari , Italy Carlo Florio
  • - Shiga University of Medical Science , Japan Akitoshi Inoue
  • - Kyungpook National University Hospital , Korea (South) Jaekwang Lim
▶ Correct Answer as Differential Diagnosis : 13/83,  15.7%
  • - Oita University, Faculty of Medicine , Japan Fumito Okada
  • - Niigata City General Hospital , Japan Takao Kiguchi
  • - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
  • - ICD,MCH CALICUT , India rikhy krishnan
  • - Onomichi municipal hospital , Japan Hirofumi Mifune
  • - Dongnam Institute of Radiological and Medical Sciences , Korea (South) Dae-Wook Yeh
  • - jaslok hospital & research centre mumbai , India JAINENDRA JAIN
  • - Chonnam university hospital , Korea (South) LEE JI HYUN
  • - Kizawa Memorial Hospital , Japan Yo Kaneko
  • - McGill university , Canada Badriya Al-Qassabi
  • - Tokyo Metropolitan Police Hospital , Japan Akifumi Hagiwara
  • - CLINIQUE STE CLOTILDE , Reunion patrick MASCAREL
  • - SNUH , Korea (South) Eui Jin Hwang
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Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

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