Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Paragonimiasis
- Radiologic Findings
- Fig 1. Chest CT shows subpleural consolidation in the left lower lobe.
Fig 2(a-b). Chest CT scans after 3 months show decreased consolidation and another new subpleural consolidation with focal air bubbles in the left lower lobe.
Fig 3. Follow-up chest CT after 5 months shows improvement of subpleural consolidation and newly appeared thin-walled tubular cavitary lesions in the left lower lobe.
Serum P. Westermani IgE Ab was positive.
- Brief Review
- Pulmonary paragonimiasis is a food-borne parasitic disease caused by the lung fluke Paragonimus westermani, which is endemic in Southeast Asia and the Far East. The most common symptoms are intermittent hemoptysis or blood-tinged sputum and cough. After ingested by humans, Paragonimus excyst in the small intestine, and the larvae penetrate through intestinal wall to gain access to the peritoneal cavity. Several weeks later, the organism travels through the diaphragm on its way to the pleural space. Next they enter the lung, where they mature to adult flukes and produce cysts that contain eggs. Paragonimiasis typically results in single of multiple 1- to 4-cm cystic spaces containing reddish brown mucinous fluid. When erosion occurs into a draining airways, the contents of the cyst may be coughed up or may spread to other portions of the lung parenchyma and result is exudative or hemorrhagic pneumonia.
The imaging manifestations of disease parallel to the life cycle of the parasites. The characteristic CT features of pulmonary paragonimiasis are round low attenuation cystic lesions filled with fluid or gas. CT scan also showed air-space consolidation, nodules, worm migration track, and bronchiectasis. The prevalence of pleural effusion varies.
- Please refer to
Case 259, Case 295, Case 349, Case 409, Case 502, Case 527, Case 537, Case 585, Case 612, Case 676, Case 684, Case 715, Case 741, Case 828, Case 885, Case 909, Case 965, Case 1021, Case 1029, Case 1075, Case 1113, Case 1125, -
KSTR Imaging Conference 2004 Spring Case 7
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KSTR Imaging Conference 2005 Spring Case 5
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KSTR Imaging conference 2009 Summer Case 12
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KSTR imaging conference cases 2010 Sprng Case 4
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KSTR Imaging conference 2010 Summer Case 6
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KSTR Imaging Conference 2014 Spring Case 1
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KSTR imaging conference 2017 Summer Case 5,
- References
- 1. Kim TS et al. Pleuropulmonary Paragonimiasis: CT Findings in 31 Pateints. AJR 2005; 185: 816-821
2. Henry TS et al. Chest CT Features of North American Paragonimiasis. AJR 2012; 198: 1078-1083
3. KN Jeon, MJ Park, KS Bae, HY Choi, HC Choi, JB Na, et al. J Korean Soc Radiol 2013;69:365-371
- Keywords
- lung, parasite , paragonimiasis,