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