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Biswal D, Shenoy M S, C B, Sureshkumar U, Acharya K V, Kamath M M, Baliga S. The Wolf in Sheep's Clothing: Incidental Pulmonary Hydatidosis masquerading as Constitutional Symptoms. Indian J Med Microbiol 2025; 53:100792. [PMID: 39863107 DOI: 10.1016/j.ijmmb.2025.100792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 01/21/2025] [Accepted: 01/22/2025] [Indexed: 01/27/2025]
Abstract
Hydatid disease, caused by Echinococcus granulosus, remains a significant health concern in endemic regions. This case report aims to highlight the diagnostic challenges of pulmonary hydatid cysts in non-endemic areas, presenting a unique case of an incidental pulmonary hydatid cyst in a 31-year-old lactating female discovered during evaluation of non-specific constitutional symptoms.
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Affiliation(s)
- Debasish Biswal
- Department of Microbiology, Amrita Institute of Medical Sciences and Research Centre, Faridabad, Haryana, India.
| | - Suchitra Shenoy M
- Department of Microbiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Bergin C
- Department of Microbiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Udaya Sureshkumar
- Department of Pulmonary Medicine, Kasturba Medical College Hospital, Ambedkar circle, Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Vishak Acharya K
- Department of Pulmonary Medicine, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Madhav Kamath M
- Department of Surgery, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
| | - Shrikala Baliga
- Department of Microbiology, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, 576104, India.
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2
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Alpaca Rodriguez LR, Kirschbaum-Chrem JP, Romero G, Villanueva E, Ugas Charcape CF. The many faces of pediatric hydatid disease: a pictorial review. Pediatr Radiol 2025; 55:115-127. [PMID: 39589488 DOI: 10.1007/s00247-024-06080-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 10/08/2024] [Accepted: 10/12/2024] [Indexed: 11/27/2024]
Abstract
Hydatid disease, caused by the larval stages of Echinococcus species, poses a significant public health challenge, especially in resource-limited cattle-producing areas of South America. The number of cases in children under the age of 15 is nearly 16% of the total cases in South America according to the latest report of the Pan American Health Organization (PAHO). The presentation of the disease depends on the anatomic location and correlates with the parasitic life stage. The liver is the most commonly affected organ in children, followed by the lungs, kidney, bone, and brain. The classification of hydatid cysts varies based on the parasite's stage, from purely cystic lesions to solid masses. The radiological approach varies by cyst location. Clinically, hydatid disease symptoms are nonspecific and organ-dependent, with imaging playing a crucial role in diagnosis. Complications include cyst rupture and superinfection, with potential severe consequences. This pictorial essay aims to illustrate the manifestations of hydatid cysts in an endemic population and highlight atypical signs for radiologists evaluating pediatric cysts in endemic regions.
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Affiliation(s)
| | - Joel P Kirschbaum-Chrem
- Instituto Nacional de Salud del Niño San Borja, Av. Javier Prado Este 3101, Lima, 15037, Peru.
| | | | | | - Carlos F Ugas Charcape
- Instituto Nacional de Salud del Niño San Borja, Av. Javier Prado Este 3101, Lima, 15037, Peru
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Hashim HT, Alhatemi AQM, Al-Obaidi AD, Al-Fatlawi N, Almusawi M, Al-Ghuraibawi MA, Al-Obiade R, Sulaiman FA, Al-Obaidi MN, Al-Awad A. Pulmonary hydatid cyst emergence post laparoscopic ovarian drilling in a clear preoperative chest: A novel case report. Radiol Case Rep 2024; 19:6542-6546. [PMID: 39391036 PMCID: PMC11465097 DOI: 10.1016/j.radcr.2024.09.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 09/10/2024] [Accepted: 09/12/2024] [Indexed: 10/12/2024] Open
Abstract
Echinococcus granulosus is the parasite that causes hydatid disease. The liver is the most often affected organ, followed by the lungs and other organs. We present the case of a 24-year-old woman who had no notable medical history prior to the presentation of a persistent cough and mild chest discomfort 3 weeks after laparoscopic ovarian drilling surgery. There were upper lobe opacities on the right side of the chest X-ray. Serology was used to confirm the diagnosis of a hydatid cyst, with computed tomography (CT) providing additional supporting evidence. This case demonstrated that, especially in endemic areas, patients presenting with atypical respiratory symptoms should have rare infectious etiologies taken into consideration during the postoperative period. After the cyst was successfully surgically removed, the patient received albendazole for antiparasitic treatment. She experienced an uneventful recovery and exhibited no clinical symptoms at follow-up.
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Affiliation(s)
- Hashim Talib Hashim
- Research Department, University of Warith Al-Anbiyaa, College of Medicine, Karbala, Iraq
| | | | | | - Nabeel Al-Fatlawi
- Internal Medicine Department, University of Baghdad, College of Medicine, Baghdad, Iraq
| | - Mustafa Almusawi
- Internal Medicine Department, University of Baghdad, College of Medicine, Baghdad, Iraq
| | | | - Reem Al-Obiade
- Internal Medicine Department, University of Baghdad, College of Medicine, Baghdad, Iraq
| | | | | | - Abdullah Al-Awad
- Internal Medicine Department, University of Baghdad, College of Medicine, Baghdad, Iraq
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Mirlohi SH, Tajfirooz S, Raji H, Akhavan S. Coexistence of kidney and lung hydatid cyst in a child: A case report. Respir Med Case Rep 2024; 52:102138. [PMID: 39717420 PMCID: PMC11665695 DOI: 10.1016/j.rmcr.2024.102138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 10/20/2024] [Accepted: 11/11/2024] [Indexed: 12/25/2024] Open
Abstract
Hydatid cyst (HC) is a zoonotic disease that often affects regions where animal husbandry is common and preventive measures are not taken. This disease mostly affects the liver and the lungs. Involvement of other organs, such as the kidney, musculoskeletal system, and intracranial structures, is rare. In this case report we will be discussing a patient who was diagnosed with bacterial pulmonary empyema without proper response to treatment. In further management, a ruptured hydatid cyst was diagnosed along with a renal hydatid cyst.
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Affiliation(s)
- Seyed Hossein Mirlohi
- Pediatric Respiratory and Sleep Medicine Research Center,Children's Medical Center,Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Tajfirooz
- Children's Medical Center, Pediatric Center of Excellence, Tehran, Iran
| | - Hojatollah Raji
- Department of Pediatric Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sima Akhavan
- Tehran University of Medical Sciences, Tehran, Iran
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Uchikov P, Ali N, Sandeva M, Kraev K, Eneva K, Hristov B, Kraeva M, Dzhambazova E, Taneva D, Tenchev T, Uchikov A. Surgical treatment of pulmonary hydatid disease: a nine-year single-center experience. Folia Med (Plovdiv) 2024; 66:653-661. [PMID: 39512033 DOI: 10.3897/folmed.66.e134503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2024] [Accepted: 09/18/2024] [Indexed: 11/15/2024] Open
Abstract
INTRODUCTION Hydatidosis is one of the most critical parasitic zoonotic diseases worldwide. Lungs are the second most common site of the disease.
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Affiliation(s)
| | - Nedzhat Ali
- Medical University of Plovdiv, Plovdiv, Bulgaria
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Wen KZ, Lim RT, Dimitri A, Noonan L, Williamson J. Complete removal of a ruptured pulmonary hydatid cyst during conscious sedation bronchoscopy: A case report and literature review. Respirol Case Rep 2024; 12:e70002. [PMID: 39247568 PMCID: PMC11377955 DOI: 10.1002/rcr2.70002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 08/04/2024] [Indexed: 09/10/2024] Open
Abstract
The complete removal of a pulmonary hydatid cyst by bronchoscopy occurs rarely in clinical practice. We describe a 22-year-old male originally from Lebanon, with suspected hydatid cyst rupture on computed tomography chest after experiencing sudden onset fevers and cough whilst taking empiric anthelmintic therapy. Bronchoscopy revealed white gelatinous material in the posterior segment of the left lower lobe. The complete membranes of a hydatid cyst were removed with grasping forceps. Histologic examination confirmed the diagnosis of echinococcosis.
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Affiliation(s)
- Kevin Ziyi Wen
- Department of Respiratory and Sleep Medicine Liverpool Hospital Sydney New South Wales Australia
| | - Ricky Tanujaya Lim
- Department of Infectious Diseases Liverpool Hospital Sydney New South Wales Australia
| | - Andrew Dimitri
- Department of Respiratory and Sleep Medicine Prince of Wales Hospital Sydney New South Wales Australia
| | - Lisa Noonan
- Department of Infectious Diseases Liverpool Hospital Sydney New South Wales Australia
| | - Jonathan Williamson
- Department of Respiratory and Sleep Medicine Liverpool Hospital Sydney New South Wales Australia
- Department of Respiratory and Sleep Medicine Macquarie University Hospital Sydney New South Wales Australia
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Chang Y, He X, Liu W, Guo H. Magnetic resonance imaging features and classification of intraspinal echinococcosis. J Orthop 2024; 55:157-162. [PMID: 38706589 PMCID: PMC11063492 DOI: 10.1016/j.jor.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/14/2024] [Indexed: 05/07/2024] Open
Abstract
Objective This study aimed to investigate the magnetic resonance imaging (MRI) features and classification of echinococcosis of the spinal canal. Methods The clinical manifestations and MRI findings and classification of 19 patients diagnosed with intraspinal echinococcosis over 10 years (2011-2020) were retrospectively analyzed. Results The mean age of the nine males and 10 females was 39 years (range 28-65 years). Among these, the number of cases with thoracic, lumbar, sacral, thoracolumbar, and lumbosacral, cervical, and lumbar segments was nine (47 %), five (26 %), one (5 %), one (5 %), two (11 %), and one (5 %) cases, respectively. Furthermore, 13 cases (69 %) involved adjacent vertebral bodies, accessories, and surrounding soft tissues. The lesion was confined to the intramedullary, extramedullary subdural, extramedullary epidural, and multiple spaces in one (Type I) (5 %), four (Type II) (21 %), one (Type III) (5 %), and thirteen (69 %) cases, respectively. Moreover, nine cases (47 %) had a history of hydatid disease in the spine or other tissues. The clinical manifestations were chest and lumbosacral pain in 18 cases (95 %) and chest and lumbosacral pain accompanied by lower limb dysfunction in four cases (21 %). The MRI revealed different sizes of T1WI low-signal and T2WI high-signal vesicles with a "grape-like" appearance, with 16 cases (84 %) showing low signals on the edge of the cyst wall. Conclusion Intraspinal echinococcosis is rare, even in endemic areas. However, intraspinal echinococcosis should be considered when there is a history of echinococcosis in other sites or when there are clear MRI characteristics for the disease.
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Affiliation(s)
- Yushan Chang
- The Fourth Affiliated Hospital of Xinjiang Medical University, Medical Imaging Center, Urumqi, Xinjiang, 830000, PR China
| | - Xiong He
- The Fourth Affiliated Hospital of Xinjiang Medical University, Medical Imaging Center, Urumqi, Xinjiang, 830000, PR China
| | - Wenya Liu
- The First Affiliated Hospital of Xinjiang Medical University, Medical Imaging Center, Urumqi, Xinjiang, 830054, PR China
| | - Hui Guo
- The Fourth Affiliated Hospital of Xinjiang Medical University, Medical Imaging Center, Urumqi, Xinjiang, 830000, PR China
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Plut D, Winant AJ, Mahomed N, Sodhi KS, Kasznia-Brown J, Williams-Weekes T, Daltro P, Das KM, Lee EY. Unusual pediatric lung infections: imaging findings. Pediatr Radiol 2024; 54:516-529. [PMID: 38097820 PMCID: PMC10984910 DOI: 10.1007/s00247-023-05818-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 04/04/2024]
Abstract
Pediatric lung infections continue to be a leading cause of pediatric morbidity and mortality. Although both pediatric and general radiologists are familiar with typical lung infections and their imaging findings in children, relatively rare lung infections continue to present a diagnostic challenge. In addition, the advances in radiological imaging and emergence of several new lung infections in recent years facilitated the need for up-to-date knowledge on this topic. In this review article, we discuss the imaging findings of pediatric lung infections caused by unusual/uncommon and new pathogens. We review the epidemiological, clinical, and radiological imaging findings of viral (coronavirus disease 2019, Middle East respiratory syndrome, bird flu), bacterial (Streptococcus anginosus, Francisella tularensis, Chlamydia psittaci), and parasitic lung infections (echinococcosis, paragonimiasis, amoebiasis). Additional disorders whose clinical course and imaging findings may mimic lung infections in children (hypersensitivity pneumonitis, pulmonary hemorrhage, eosinophilic pneumonia) are also presented, to aid in differential diagnosis. As the clinical presentation of children with new and unusual lung infections is often non-specific, imaging evaluation plays an important role in initial detection, follow-up for disease progression, and assessment of potential complications.
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Affiliation(s)
- Domen Plut
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000, Ljubljana, Slovenia.
- Department of Pediatric Radiology, Clinical Radiology Institute, University Medical Centre Ljubljana, Zaloška cesta 2, 1000, Ljubljana, Slovenia.
| | - Abbey J Winant
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Nasreen Mahomed
- Department of Radiology, University of Witwatersrand, Johannesburg, South Africa
| | - Kushaljit Singh Sodhi
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
- Department of Radiodiagnosis, PGIMER, Chandigarh, India
| | | | | | - Pedro Daltro
- Department of Radiology, Clínica de Diagnóstico por Imagem, Rio de Janeiro, Brazil
| | - Karuna M Das
- Department of Radiology, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Edward Y Lee
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
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Zendeoui A, Gharbi MA, Nefiss M, Ezzine MH, Tborbi A, Bouzidi R. Primary extrahepatic hydatid cyst of the thigh, an unusual presentation of sciatica: A case report of a diagnostic challenge. Int J Surg Case Rep 2024; 117:109545. [PMID: 38518474 PMCID: PMC10973717 DOI: 10.1016/j.ijscr.2024.109545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/08/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024] Open
Abstract
INTRODUCTION Sciatica, a condition characterized by pain along the sciatic nerve distribution, is commonly associated with nerve compression or irritation. However, its etiology can vary, including rare non-spinal causes such as hydatid cysts. We present a case of hydatid cyst in the thigh causing sciatica-like symptoms, highlighting the diagnostic challenges and management approach. CASE PRESENTATION A 40-year-old patient with a history of pulmonary tuberculosis presented with persistent lumbosciatic pain despite conservative treatment. Physical examination revealed left sciatica without spinal abnormalities. MRI revealed a hydatid cyst in the thigh, causing nerve irritation. Surgical resection of the cyst was performed, achieving symptom resolution. DISCUSSION Hydatid cysts in skeletal muscles are rare, with atypical presentations complicating diagnosis. Localization in the thigh, particularly the biceps femoris muscle, is uncommon. Diagnostic modalities include imaging and serological tests, while treatment involves surgical excision and postoperative albendazole therapy. CONCLUSION Recognition of rare presentations like thigh hydatid cysts causing sciatica-like symptoms is crucial for timely diagnosis and management. This case emphasizes the importance of considering unusual etiologies in refractory sciatica cases and underscores the complexity of medical diagnosis. Increased awareness among healthcare providers can lead to improved patient outcomes and prevent diagnostic delays.
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Affiliation(s)
| | | | - Mouadh Nefiss
- Orthopaedic Department, Mongi Slim Hospital, Tunisia
| | | | - Anis Tborbi
- Orthopaedic Department, Mongi Slim Hospital, Tunisia
| | - Ramzi Bouzidi
- Orthopaedic Department, Mongi Slim Hospital, Tunisia
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10
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Zhang N, Vuppala NK, Boney CP, Moon J, Liengswangwong R, Ahn HJC, Tine A, Kendall TJ. Primary Pulmonary Echinococcosis in the United States: A Case Report and Review of the Literature. Cureus 2024; 16:e55591. [PMID: 38576653 PMCID: PMC10994676 DOI: 10.7759/cureus.55591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
We depict a unique case of a 34-year-old woman who presents to the emergency department with complaints of dyspnea and chest pain for the past month. A chest x-ray (CXR) from an earlier urgent care visit was concerning for large fluid opacity in the left lung and follow-up imaging revealed a cystic mass suspicious of a pulmonary cystic abscess. The patient underwent complete lobectomy and resection. Post-surgical biopsy confirmed pulmonary hydatid cystic mass and signs of rupture or seeding to liver tissue. The patient was discharged with adjuvant therapy and recommended imaging follow-up for the next decade. The diagnosis, treatment, and maintenance guidelines are discussed in this report which reveals controversy between experts given the lack of complete literature regarding echinococcosis. Our purpose in putting forward this case is to present a rare diagnosis of pulmonary echinococcosis in the United States and to emphasize the importance of early imaging and diagnosis to prevent cystic rupture and secondary organ dissemination.
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Affiliation(s)
- Nathan Zhang
- Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Neil K Vuppala
- Medicine, Alabama College of Osteopathic Medicine, Huntsville, USA
| | - Colton P Boney
- Medicine, Alabama College of Osteopathic Medicine, Huntsville, USA
| | - Justin Moon
- Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | | | - Heong Jin C Ahn
- Internal Medicine, Alabama College of Osteopathic Medicine, Dothan, USA
| | - Albert Tine
- Research, Alabama College of Osteopathic Medicine, Dothan, USA
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11
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Sadr S, Lotfalizadeh N, Abbasi AM, Soleymani N, Hajjafari A, Roohbaksh Amooli Moghadam E, Borji H. Challenges and Prospective of Enhancing Hydatid Cyst Chemotherapy by Nanotechnology and the Future of Nanobiosensors for Diagnosis. Trop Med Infect Dis 2023; 8:494. [PMID: 37999613 PMCID: PMC10674171 DOI: 10.3390/tropicalmed8110494] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023] Open
Abstract
Hydatid cysts have been widely recognized for decades as a common medical problem that affects millions of people. A revolution in medical treatment may be on the prospect of nanotechnology enhancing chemotherapy against hydatid cysts. An overview of nanotechnology's impact on chemotherapeutics is presented in the current review. It discusses some of the challenges as well as some of the opportunities. The application of nanotechnology to enhance chemotherapy against hydatid cysts is what this review will explore. Nanotechnology is a critical component of delivering therapeutic agents with greater precision and efficiency and targeting hydatid cysts with better efficacy, and minimizing interference with surrounding tissue. However, there are biodistribution challenges, toxicity, and resistance problems associated with nanotherapeutics. Additionally, nanobiosensors are being investigated to enable the early diagnosis of hydatid cysts. A nanobiosensor can detect hydatid cysts by catching them early, non-invasively, rapidly, and accurately. The sensitivity and specificity of diagnostic tests can be enhanced with nanobiosensors because they take advantage of the unique properties of nanomaterials. By providing more precise and customized treatment options for hydatid cysts, nanotechnology may improve therapeutic options and strategies for diagnosing the disease. In conclusion, treatment with nanotechnology to treat hydatid cysts is potentially effective but presents many obstacles. Furthermore, nanobiosensors are being integrated into diagnostic techniques, as well as helping to diagnose patients earlier and more accurately.
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Affiliation(s)
- Soheil Sadr
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
| | - Narges Lotfalizadeh
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
| | - Amir Mohammad Abbasi
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
| | - Nooshinmehr Soleymani
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
| | - Ashkan Hajjafari
- Department of Pathobiology, Faculty of Veterinary Medicine, Islamic Azad University, Science and Research Branch, Tehran 1477893855, Iran
| | | | - Hassan Borji
- Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad 917794897, Iran; (S.S.)
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Patnam N, Trivedi K, Janu A, Kaushal RK, Kulkarni S, Ankathi SK. Cross-sectional imaging review of common to uncommon lung cancer mimickers in a tertiary care oncology center. Acta Radiol 2023; 64:2731-2747. [PMID: 37592920 DOI: 10.1177/02841851231191987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Lung cancer is the most diagnosed cancer worldwide. Many non-malignant pulmonary lesions, such as tuberculosis, fungal infection, organizing pneumonia, inflammatory myofibroblastic tumor, and IgG4 disease, can mimic lung cancer due to their overlapping morphological appearance on imaging. These benign entities with minor differentiating imaging clues may go unnoticed in a high-volume cancer institution, leading to over-investigation that may result in repeated biopsies, pointless wedge resections, and related morbidities. However, with a thorough medical history, laboratory diagnostic work-up, and careful analysis of imaging findings, one can occasionally restrict the range of possible diagnoses or arrive at a definitive conclusion. When imaging features overlap, image-guided lung sampling is crucial since histopathological analysis is the gold standard.
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Affiliation(s)
- Nandakumar Patnam
- Department of Radiodiagnosis and Interventional Radiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Kamaxi Trivedi
- Department of Radiodiagnosis and Interventional Radiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Amit Janu
- Department of Radiodiagnosis and Interventional Radiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rajiv Kumar Kaushal
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Suyash Kulkarni
- Department of Radiodiagnosis and Interventional Radiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Suman Kumar Ankathi
- Department of Radiodiagnosis and Interventional Radiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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13
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Lees EA, Ives A, Fowler D, Lakhoo K, Grant D, Kelly D, Paulus S, Segal S, Gilchrist JJ, Kew A, Chiodini P, Kadambari S. Pulmonary Cystic Echinococcosis in a Child Presenting in the United Kingdom with Fever and Chest Pain: A Brief Report and Discussion on Management. Pediatr Infect Dis J 2023; 42:e343-e345. [PMID: 37200507 PMCID: PMC10417314 DOI: 10.1097/inf.0000000000003968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/20/2023]
Abstract
Cystic echinococcosis is a zoonosis caused by the larvae of Echinococcus granulosus . Pulmonary disease may be asymptomatic until the cyst ruptures or becomes secondarily infected. We report a case of pulmonary cystic echinococcosis presenting in the United Kingdom, with discussion on management: optimum antihelminthic agent, length of treatment and type of operative intervention. Treatment should be individualized to the clinical scenario.
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Affiliation(s)
- Emily A. Lees
- From the Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
- Fitzwilliam College, University of Cambridge, United Kingdom
| | - Andrew Ives
- From the Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Darren Fowler
- Department of Pathology, John Radcliffe Hospital, Oxford, United Kingdom
| | - Kokila Lakhoo
- Department of Paediatric Surgery, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - David Grant
- Department of Paediatric Radiology, John Radcliffe Hospital, Oxford, United Kingdom
| | - Dominic Kelly
- From the Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
- Oxford Vaccine Group and NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, United Kingdom
| | - Stéphane Paulus
- From the Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Shelley Segal
- From the Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - James J. Gilchrist
- From the Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
| | - Alex Kew
- Hospital for Tropical Diseases, University College London, United Kingdom
| | - Peter Chiodini
- Hospital for Tropical Diseases, University College London, United Kingdom
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Seilesh Kadambari
- From the Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom
- Department of Paediatric Infectious Diseases, Great Ormond Street Hospital, London, United Kingdom
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14
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Alhomsi MY, Almoshantaf MB, Homsieh SB. Traumatic occult pneumothorax and ipsilateral hydatid cyst: A case report. Int J Surg Case Rep 2023; 110:108647. [PMID: 37597430 PMCID: PMC10460941 DOI: 10.1016/j.ijscr.2023.108647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/04/2023] [Accepted: 08/05/2023] [Indexed: 08/21/2023] Open
Abstract
INTRODUCTION Traumatic pneumothorax is a common chest condition that can be caused by a chest trauma. Hydatid cysts are also common, especially in Syria, and is caused by Echinococcus granulosis infection. CASE PRESENTATION We report a case of mutual presentation of pneumothorax and a large Hydatid cyst on the same chest side in an 18 years-old patient who got stabbed in the chest. The chest x-ray reveled well-defined, homogeneous radio-opacity lesion that is consistent with Hydatid cyst but no pneumothorax was observed. Later, the chest CT showed a small pneumothorax that coexist with the Hydatid cyst. The case was treated conservatively and the patient survived. DISCUSSION Some studies support treating asymptomatic trauma patients with occult PT with observation and placing a chest tube if still asymptomatic. Our case questions the management protocol for such a rare encounter as the stability status of the patient was poor, and there was a large hydatid cyst close to the chest wall. CONCLUSION Physicians should be aware of the possible management solutions when dealing with similar cases, especially in emergency settings. Until clear guidelines are published for this matter, we recommend that high-level observation of the patient's vitals are the determining factor for suitable intervention.
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Reddy A, Mathew JL, Kundu R, Menon P, Gupta K. A Child With a Brief History of Coughing Up Blood. Pediatr Infect Dis J 2023; 42:829-832. [PMID: 37579062 DOI: 10.1097/inf.0000000000003899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Affiliation(s)
- Anvesh Reddy
- From the Pediatric Pulmonology Division, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Joseph L Mathew
- From the Pediatric Pulmonology Division, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Reetu Kundu
- Department of Cytology and Gynaecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Prema Menon
- Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kirti Gupta
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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16
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Maggioni G, Bonis A, Schiavon M, Giraudo C, Lunardi F, Pezzuto F, Calabrese F. An unexpected guest: Pulmonary echinococcosis diagnosed by intraoperative frozen section examination. A case report and literature review. Pathol Res Pract 2023; 248:154615. [PMID: 37343377 DOI: 10.1016/j.prp.2023.154615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 06/23/2023]
Abstract
Echinococcosis is caused by tapeworms belonging to the Echinococcus genus. The most common site of infection is the liver although it may involve almost any organ. Symptoms of pulmonary echinococcosis vary depending on the location and structure of the cyst. While uncomplicated cysts usually appear at imaging as well-defined homogeneous lesions with fluid content and smooth walls of variable thickness, complicated lesions may have a more heterogeneous content with higher density making more difficult the distinction from malignancies or other infections. Hereby we describe the case of a 61-year-old Northern African male admitted to our tertiary center for left upper chest pain who then underwent a chest computed tomography (CT) scan which demonstrated a large hypodense lesion, with smooth and thick walls, in the upper left lobe. The following magnetic resonance confirmed the homogeneous fluid content, and the 18 F- fluorodeoxyglucose-positron emission tomography/CT demonstrated a mild uptake of the walls. According to these findings, the main differential diagnoses at imaging included bronchogenic cyst, synovial sarcoma, and pulmonary hematoma although the patient denied any recent trauma. Given the large size and clinical symptoms he underwent surgery. Intra-operative frozen section, supported by imprint cytology, excluded the presence of malignancy while suggested an echinococcal laminar exocyst. The final pathological examination confirmed the diagnosis of echinococcosis (i.e., Echinococcus Granulosus protoscolex). After surgery he was treated with albendazole and at the six-month follow-up he was in good clinical conditions. Our case highlights the importance of considering rare infections, particularly in individuals from endemic areas. Frozen tissue analyses can be a diagnostic challenge and often require ancillary tools such as imprint cytology and serial sections for more sensitive and accurate diagnosis.
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Affiliation(s)
- Giuseppe Maggioni
- Anatomic Pathology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy
| | - Alessandro Bonis
- Thoracic Surgery Unit, Department of Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35121 Padua, Italy
| | - Marco Schiavon
- Thoracic Surgery Unit, Department of Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35121 Padua, Italy
| | - Chiara Giraudo
- Radiology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy
| | - Francesca Lunardi
- Anatomic Pathology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy
| | - Federica Pezzuto
- Anatomic Pathology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy
| | - Fiorella Calabrese
- Anatomic Pathology Unit, Department of Medicine, University of Padua, 35121 Padua, Italy.
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Aydin Y, Ulas AB, Eroglu A. Calcification in a pulmonary hydatid cyst: a rare radiological appearance. Br J Hosp Med (Lond) 2023; 84:1. [PMID: 37364883 DOI: 10.12968/hmed.2022.0540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Affiliation(s)
- Yener Aydin
- Department of Thoracic Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Ali Bilal Ulas
- Department of Thoracic Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Atilla Eroglu
- Department of Thoracic Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
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18
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Messaoud O, El Haddad S, Cherraqi A, Allali N, Chat L. Tension Hydropneumothorax Caused by a Ruptured Hydatic Cyst in the
Pleural Cavity: Case Report. Glob Pediatr Health 2023; 10:2333794X231156044. [PMID: 36968457 PMCID: PMC10031588 DOI: 10.1177/2333794x231156044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/20/2023] [Indexed: 03/24/2023] Open
Abstract
Hydatid disease is a zoonosis caused by a larva of the tapeworm Echinococcus. All
organs can be involved, but it is frequently located in liver for adults and
lung for children. The clinical features are nonspecific. Imaging findings has
an important place in the diagnosis and the follow-up. Rupture is the most
common complication of a hydatic cyst and has a variety of imaging findings
depending on the ruptured layer, the amount of air within the cyst and the type
rupture. We report the case of a 10-year-old boy presenting shortness of breath
and fever among other symptoms revealing by chest X-ray and thoracic CT scan, a
lung ruptured hydatic cyst to the pleural cavity causing a tension
hydro-pneumothorax and a superadded infection.
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Affiliation(s)
- Ola Messaoud
- Mother and Child Hospital IBN SINA,
Rabat, Morocco
- Ola Messaoud, Centre
Hospitalo-Universitaire Ibn Sina, International Hospital IBN SINA, Rabat 10170,
Morocco.
| | | | | | - Nazik Allali
- Mother and Child Hospital IBN SINA,
Rabat, Morocco
| | - Latifa Chat
- Mother and Child Hospital IBN SINA,
Rabat, Morocco
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19
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Alshoabi SA, Alkalady AH, Almas KM, Magram AO, Algaberi AK, Alareqi AA, Hamid AM, Alhazmi FH, Qurashi AA, Abdulaal OM, Aloufi KM, Alsharif WM, Alsultan KD, Omer AM, Gareeballah A. The Neoplasms Mimicker: A Pictorial Review of Hydatid Disease. Diagnostics (Basel) 2023; 13:diagnostics13061127. [PMID: 36980435 PMCID: PMC10047450 DOI: 10.3390/diagnostics13061127] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
Hydatid cyst is a common name for the larval stage of a tapeworm species of the genus Echinococcus granulosus, which is transmitted from animals to humans via the fecal–oral route. Hydatid cysts predominantly affect the liver (75%), followed by the lung (15%), and they can affect many organs in the human body. Medical imaging modalities are the keystone for the diagnosis of hydatid cysts with high sensitivity and specificity. Ultrasound imaging with high resolution is the first choice for diagnosis, differential diagnosis, staging, establishing a role in interventional management, and follow-up, and it can differentiate Type I hydatid cysts from simple liver cysts. Unenhanced computed tomography (CT) is indicated where or when an ultrasound is unsatisfactory, such as with chest or brain hydatid cysts, when detecting calcification, and in obese patients. Magnetic resonance imaging (MRI) is superior for demonstrating cyst wall defects, biliary communication, neural involvement, and differentiating hydatid cysts from simple cysts using diffusion-weighted imaging (DWI) sequences. According to the phase of growth, hydatid cysts occur in different sizes and shapes, which may mimic benign or malignant neoplasms and may create diagnostic challenges in some cases. Hydatid cysts can mimic simple cysts, choledochal cysts, Caroli’s disease, or mesenchymal hamartomas of the liver. They can mimic lung cystic lesions, mycetoma, blood clots, Rasmussen aneurysms, and even lung carcinomas. Differential diagnosis can be difficult for arachnoid cysts, porencephalic cysts, pyogenic abscesses, and even cystic tumors of the brain, and can create diagnostic dilemmas in the musculoskeletal system.
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Affiliation(s)
- Sultan Abdulwadoud Alshoabi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
- Correspondence:
| | | | | | | | | | - Amal A. Alareqi
- Radiology Department, 21 September University of Medical and Applied Science, Sana’a, Yemen
| | | | - Fahad H. Alhazmi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Abdulaziz A. Qurashi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Osamah M. Abdulaal
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Khalid M. Aloufi
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Walaa M. Alsharif
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Kamal D. Alsultan
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Awatif M. Omer
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
| | - Awadia Gareeballah
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah 42353, Saudi Arabia
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20
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Manoharan A, Ayub II, Arshad AM, Chockalingam C, Thangaswamy D. Cough, with a sac of marbles in the chest. Lung India 2023; 40:175-176. [PMID: 37006105 PMCID: PMC10174646 DOI: 10.4103/lungindia.lungindia_506_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/02/2022] [Accepted: 01/09/2023] [Indexed: 03/05/2023] Open
Affiliation(s)
- Amuthapriya Manoharan
- Department of Pulmonary Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Irfan Ismail Ayub
- Department of Pulmonary Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Abdul Majeed Arshad
- Department of Pulmonary Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Chandrasekar Chockalingam
- Department of Pulmonary Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - Dhanasekar Thangaswamy
- Department of Pulmonary Medicine, Sri Ramachandra Medical College and Research Institute, Chennai, India
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21
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Sadjjadi FS, Hajjaran H, Sedaghat B, Mardani P, Sadjjadi SM. Proteomics investigation of human sera for determination of postoperative indicators of pulmonary cystic echinococcosis. J Cardiothorac Surg 2023; 18:18. [PMID: 36631795 PMCID: PMC9832791 DOI: 10.1186/s13019-023-02109-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Cystic echinococcosis (CE)/hydatidosis is an important zoonotic parasitic disease caused by the larval stage of Echinococcus granulosus. The disease is a major health problem all over the world. Finding specific and sensitive biomarkers for follow-up of CE in patients after surgery is essential. Using proteomics methods, the present study aimed to evaluate post-surgical treatment by finding probable biomarker/s in the serum of human lungs CE. METHODS A total of 24 human sera were tested. These sera included eight confirmed lung/s CE patients sera before surgery (BS), eight sera 12 months post-surgery (12MPS) as well as eight control sera from healthy people. Proteomics methods including 2DE and LC-MS/MS were performed on the specimens followed by bioinformatics analysis. Differentially expressed proteins (DEP) were detected and, separately integrated with protein-protein interaction (PPI) data to construct the PPI network. RESULTS A total of 171 protein spots were detected in three groups including BS, 12MPS, and control groups; of which a total of 106 DEP have been expressed based on fold changes > = 2 and p-value < 0.05. More analysis was performed and a total of 10 protein spots were selected for identification by mass spectrometry showing the following proteins: APOA1, BGN, SPP2, EAF1, ACOXL, MRPL55, MCTP2, SEPTIN1, B4GALNT1, and ZNF843. Based on centrality parameters of the PPI network (degree and betweenness) five Hub-bottlenecks proteins with significant centrality values were found including APOA1, BGN, SPP2, EAF1, and ACOXL. CONCLUSION This study showed five proteins as hub-bottleneck proteins; of which APOA1 was more prominent. It can be concluded that a change in expression of this protein in patients' sera could be used as an indicator tool for the achievement of lungs CE surgical therapy.
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Affiliation(s)
- Fatemeh Sadat Sadjjadi
- grid.411600.2Proteomics Research Center, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa Hajjaran
- grid.411705.60000 0001 0166 0922Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Sedaghat
- grid.412571.40000 0000 8819 4698Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parviz Mardani
- grid.412571.40000 0000 8819 4698Department of Surgery, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mahmoud Sadjjadi
- Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
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22
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Al-Tawfiq JA, Kim H, Memish ZA. Parasitic lung diseases. Eur Respir Rev 2022; 31:31/166/220093. [DOI: 10.1183/16000617.0093-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/20/2022] [Indexed: 12/02/2022] Open
Abstract
Parasitic lung diseases are caused by a number of parasites as a result of transient passage in the lung or as a result of an immunologic reaction. The clinical presentation may be in the form of focal or cystic lesions, pleural effusion or diffuse pulmonary infiltrates. With increasing globalisation, it is important to consider parasitic infections in the differential diagnosis of lung diseases. This is particularly important since early identification and prompt therapy result in full cure of these conditions. In this review, we summarise the most common parasitic lung diseases.
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23
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Aydin Y, Ulas AB, Ahmed AG, Eroglu A. Pulmonary Hydatid Cyst in Children and Adults: Diagnosis and Management. Eurasian J Med 2022; 54:133-140. [PMID: 36655457 PMCID: PMC11163342 DOI: 10.5152/eurasianjmed.2022.22289] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/21/2022] [Indexed: 01/19/2023] Open
Abstract
Hydatid cyst disease induced by Echinococcus granulosus is a parasitic disease known since ancient times. Today, it continues to be seen in many countries and creates serious problems. The lung is the second most frequently affected organ by hydatid cysts after the liver. Lung involvement is more prevalent in children than adults, and the growth of the cyst is faster in children. Hydatid cysts are mostly seen in the right lower lobe of the lung. Common symptoms are chest pain, cough, and shortness of breath, with the most diagnostic symptom being the expectoration of cyst fluid or membranes. In endemic areas, the diagnosis of hydatid cysts can usually be made easily by clinical findings, serology tests, and radiological findings. When the hydatid cyst ruptures and becomes complicated, it is clinically and radiologically confused with many diseases, especially lung cancer. Surgery is accepted as primary treatment of lung hydatid cysts all over the world. The surgical approach is related to several factors such as the size of the cyst, whether it is intact or complicated, unilateral or bilateral, solitary or multiple, and the presence of destruction of the lung parenchyma. Although it is stated by some surgeons that capitonnage is not required, the most frequently applied surgical technique is cystotomy and capitonnage. Pulmonary resection should be avoided as much as possible, particularly in children. Albendazole or mebendazole treatment in pulmonary hydatid cyst is generally used after surgery and to prevent recurrences.
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Affiliation(s)
- Yener Aydin
- Department of Thoracic Surgery, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Ali Bilal Ulas
- Department of Thoracic Surgery, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Ayman Gaffar Ahmed
- Department of Thoracic Surgery, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Atilla Eroglu
- Department of Thoracic Surgery, Ataturk University, Medical Faculty, Erzurum, Turkey
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24
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Yaldız D, Batıhan G, Ceylan KC, Yaldız S, Susam S. Pitfalls in the surgical treatment of undiagnosed lung lesions and cystic pulmonary hydatidosis. J Cardiothorac Surg 2022; 17:275. [PMID: 36303186 PMCID: PMC9615253 DOI: 10.1186/s13019-022-02026-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/20/2022] [Indexed: 12/02/2022] Open
Abstract
Background Hydatid cysts can mimic many lung pathologies radiologically, as well as some malignant or benign lung tumors may show hydatid cyst-like radiological features. The aim of our study is to present our clinical experience and recommendations by analyzing the cases that create diagnostic difficulties by presenting a common radiological pattern with a pulmonary hydatid cyst.
Methods The patients who were operated on with a preliminary diagnosis of hydatid cyst but were diagnosed differently, and who were operated on with different prediagnoses and unexpectedly diagnosed with hydatid cyst were included in the study. The clinical and radiological features of the patients were documented, and the features of the cases that could cause difficulties in diagnosis and treatment for the surgeon were revealed.
Results A total of 20 patients who were radiologically suggestive of hydatid cyst but were diagnosed differently or unexpectedly diagnosed as hydatid cyst were included in the study. Lung cancer, bronchogenic cyst, or bronchiectasis were detected in 13 patients who were radiologically suggestive of hydatid cyst. There were 7 patients who were diagnosed with hydatid cysts, although they did not have specific radiological findings. Conclusions While hydatid cysts can mimic many lung pathologies, many benign or malign parenchymal lung pathologies may exhibit hydatid cyst-like radiological features. Therefore, in regions where a hydatid cyst is endemic, the surgeon should consider all possibilities while managing the cases. Clinical registration number: Institutional Review Board of the Dr Suat Seren Chest Diseases and Chest Surgery Education and Research Center (No. 49109414-604.02).
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Affiliation(s)
- Demet Yaldız
- Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Güntuğ Batıhan
- Kars State Hospital, Kars, Turkey. .,Department of Thoracic Surgey, Dr Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Sciences Turkey, Yenişehir, Gaziler Street 331, 35110, Izmir, Turkey.
| | - Kenan Can Ceylan
- Department of Thoracic Surgey, Dr Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Sciences Turkey, Yenişehir, Gaziler Street 331, 35110, Izmir, Turkey
| | - Sadık Yaldız
- Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Seher Susam
- Department of Thoracic Surgey, Dr Suat Seren Chest Diseases and Chest Surgery Training and Research Hospital, University of Health Sciences Turkey, Yenişehir, Gaziler Street 331, 35110, Izmir, Turkey
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Abstract
Echinococcosis is a worldwide public health problem causing considerable paediatric morbidity and mortality in endemic areas. The presentation of cystic echinococcosis (CE) varies by age. Unlike adults, where hepatic involvement is common, pulmonary CE is the dominant site in the paediatric population. Pulmonary cysts are typically first seen on chest X-ray, either as an incidental finding or following respiratory symptoms after cyst rupture or secondary infection of the cyst. In children, pulmonary cysts have a broad differential diagnosis, and a definitive diagnosis relies on the combination of imaging, serology, and histology. In countries with high infectious burdens from diseases such as acquired immunodeficiency syndrome (AIDS) and tuberculosis (TB), the diagnosis is additionally challenging, as atypical infections are more common than in developed countries. Pulmonary CE is treated with a combination of surgery and chemotherapy.
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26
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Arega G, Kebede RA, Woldeselassie HG, Lingerh T, Yayeh T. Bilateral Large Pulmonary Hydatid Cyst: A Rare Presentation in a Young Child from Ethiopia. Pediatric Health Med Ther 2022; 13:279-282. [PMID: 35983161 PMCID: PMC9380727 DOI: 10.2147/phmt.s374091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
Hydatidosis is a parasitic disease caused by Echinococcus granulosus, which is endemic in many parts of the world. Hydatid cysts can occur in any organ of the human body and the lung is the most common site in children, primarily related to higher lung tissue elasticity. Bilateral pulmonary hydatid cyst is a rare clinical phenomenon in young children. Here, we report on a 3-year-old boy diagnosed with bilateral pulmonary hydatid cyst after he came with four months history of dry cough and progressive worsening of shortness of breath. Computed tomography of the chest revealed large bilateral thick-walled pulmonary cystic mass lesions, with bilateral perihilar extension and pressure effect on the diaphragm with surrounding atelectatic changes. The patient underwent left posterolateral thoracotomy and cyst excision was done for the left hydatid cyst. Two months after the first surgical cyst excision, right posterolateral thoracotomy and cystectomy was done for the right lung hydatid cyst. He recovered well post-operatively.
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Affiliation(s)
- Gashaw Arega
- Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, Addis Ababa, Ethiopia
- Correspondence: Gashaw Arega, Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, P.O.Box: 9080, Addis Ababa, Ethiopia, Tel +251911417235, Email
| | - Rahel Argaw Kebede
- Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, Addis Ababa, Ethiopia
| | | | - Temesgen Lingerh
- Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, Addis Ababa, Ethiopia
| | - Tadele Yayeh
- Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, Addis Ababa, Ethiopia
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27
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Yoldaş B, Gürsoy S, Budak E, Gülmez B, Ceylan KC, Çırak AK, Susam S, Güldaval F, Gayaf M, Şanlı B, Yazgan S, Sevinç S. FDG PET/CT signs of proven pulmonary hydatid cyst: is there any clue? Jpn J Radiol 2022; 40:1194-1200. [PMID: 35727457 DOI: 10.1007/s11604-022-01296-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Pulmonary hydatid cyst (PHC) can imitate many diseases. Sometimes, positron emission tomography/computed tomography (PET/CT) is performed in terms of malignancy exclusion for complicated cysts. Although some specific findings (doughnut sign) have been identified in hydatid cyst of the liver, there is no specific sign described for PHC. The aim of this study is to investigate the presence of a common finding in PHC patients scanned with PET/CT inadvertently. MATERIALS AND METHODS From January 2015 to 2020, patients proven to have PHC were analyzed retrospectively. From all the patients, only 17, having a previous PET/CT, were included the study. Lesions were evaluated in three groups according to FDG uptake: A, negative; B, focal; C, doughnut sign. RESULTS The total number of patients was 17. Nine of the patients were male and the median age was 41.94 + 14.68 (16-65) years. SUV max of the lesions ranged from 0.5 to 15.8 (mean ± SE: 4.68). According to the FDG uptake of the lesions, five were in Group A, two in Group B, and the remaining ten (58.8%) in Group C with doughnut sign. To correlate the CT findings with PET/CT findings, doughnut sign, which is a typical finding of hydatid cysts of liver, is seen in only four patients in Group 1-classified cysts which are non-complicated. But in Group 2 (n = 3) and 3(n = 4), the finding of doughnut sign is three in both groups. CONCLUSIONS PET/CT is not a recommended imaging technique for PHC, but in cases where a definitive diagnosis is difficult, interpreting PET/CT findings is significant. This study demonstrates that previously described doughnut sign for liver hydatid cysts is also common for perforated pulmonary cysts. According to our knowledge, this is the first largest series of determining PET/CT findings of PHC. Further larger series will contribute to the literature.
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Affiliation(s)
- Banu Yoldaş
- Department of Thoracic Surgery, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Dr Suat Seren Chest Diseases and Surgery Medical Practice and Research Center, Izmir, Turkey.
| | - Soner Gürsoy
- Department of Thoracic Surgery, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Dr Suat Seren Chest Diseases and Surgery Medical Practice and Research Center, Izmir, Turkey
| | - Emine Budak
- Department of Nuclear Medicine, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Izmir, Turkey
| | - Barış Gülmez
- Department of Thoracic Surgery, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Dr Suat Seren Chest Diseases and Surgery Medical Practice and Research Center, Izmir, Turkey
| | - Kenan C Ceylan
- Department of Thoracic Surgery, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Dr Suat Seren Chest Diseases and Surgery Medical Practice and Research Center, Izmir, Turkey
| | - Ali K Çırak
- Department of Pulmonology, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Izmir, Turkey
| | - Seher Susam
- Department of Radiology, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Izmir, Turkey
| | - Filiz Güldaval
- Department of Pulmonology, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Izmir, Turkey
| | - Mine Gayaf
- Department of Pulmonology, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Izmir, Turkey
| | | | - Serkan Yazgan
- Department of Thoracic Surgery, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Dr Suat Seren Chest Diseases and Surgery Medical Practice and Research Center, Izmir, Turkey
| | - Serpil Sevinç
- Department of Thoracic Surgery, Izmir Dr. Suat Seren Chest Diseases and Surgery Education and Research Hospital, Dr Suat Seren Chest Diseases and Surgery Medical Practice and Research Center, Izmir, Turkey
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A Multi-diagnostic Screening Study of the Prevalence and Risk Factors of Echinococcosis in First-degree Family Members of Infected Patients Undergoing Surgical Treatment. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2022. [DOI: 10.5812/archcid-101569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Echinococcosis is a zoonotic infection caused by Echinococcus tapeworms. About 60% of patients remain asymptotic until severe stages. Early diagnosis of the infection in high-risk populations is of medical importance. Objectives: This study was designed to investigate the prevalence of echinococcosis among first-degree family members of the infected patients who underwent surgical treatment. Methods: A cross-sectional study was conducted to screen the first-degree family members of 96 patients who underwent surgical intervention at Imam Reza hospital, Mashhad, Iran, from September 2016 to March 2017. All family members were invited by phone calls to perform the serologic test, ultrasound examination, and chest X-ray test. Results: Forty-six (47.9%) patients participated in the study. A total of 114 family members performed the screening tests. Seven participants from five families (6.14%) were found to be infected in ultrasound examination (five females with a mean age of 36 years). There were no significant differences between the infected and non-infected groups concerning age (P = 0.921) and gender (P = 0.457). Conclusions: Screening the first-degree family members of patients with a confirmed echinococcosis infection results in the early diagnosis of infected patients, which is economically significant, especially in endemic areas.
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Rydzak CE, Lima AS, Meirelles GS. Endemic Thoracic Infections in Sub-Saharan Africa. Radiol Clin North Am 2022; 60:461-479. [DOI: 10.1016/j.rcl.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Greenberg DJ, Canoy J, Tomac Pavosevic H, Epelbaum O. Pulmonary Cystic Echinococcosis. Mayo Clin Proc 2022; 97:752-753. [PMID: 35379421 DOI: 10.1016/j.mayocp.2022.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 10/18/2022]
Affiliation(s)
| | | | | | - Oleg Epelbaum
- Division of Pulmonary, Critical Care and Sleep Medicine, Westchester Medical Center, Valhalla, NY, USA
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Jain R, Jana M, Gupta A, Naranje P. Ultrasonography in the Evaluation of Pediatric Chest "Masses": When to Consider? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:821-826. [PMID: 34173674 DOI: 10.1002/jum.15770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 06/13/2023]
Abstract
Thoracic ultrasound is radiation-free, easily available, portable modality with added advantage of real-time assessment. It is useful in mediastinal lesions and peripheral lung, pleural and chest wall masses. Not only is it a valuable modality in differentiating solid from cystic lesion, it can also depict internal architecture without the use of contrast material. The added advantages of its use in children are the lack of ionizing radiation, and no need for sedation or general anesthesia in most cases. Although it has its limitations with a longer learning curve, it can act as a second-line modality to chest radiograph and adjunctive modality to CT in cases of a thoracic mass in a child.
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Affiliation(s)
- Rupali Jain
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Naranje
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
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Datta P, Sharma B, Peters NJ, Khurana S, Sehgal R. Bilateral Pulmonary Hydatid Cyst in a Young Child: A Rare Case Report from North India. J Lab Physicians 2022; 14:348-350. [PMID: 36119419 PMCID: PMC9473927 DOI: 10.1055/s-0042-1742420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Echinococcosis or hydatid disease is caused by the larval stage of the dog tapeworm, that is,
Echinococcus granulosus
,
E. multilocularis
,
E. vogeli
, or
E. oligarthrus
.
Echinococcus granulosus
causes cystic echinococcosis, which has a worldwide distribution. Liver is the most common site, affecting approximately two-third of the patients, whereas lung involvement is seen in approximately 25% of cases. This case is a very rare scenario of bilateral pulmonary hydatid cysts in a young child having exposure to a pet dog with negative hydatid serology and normal eosinophil count.
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Affiliation(s)
- Priya Datta
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Bhawna Sharma
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nitin James Peters
- Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sumeeta Khurana
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Sehgal
- Department of Medical Parasitology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Vázquez-Pérez Á, Santos-Pérez JL. Cystic echinococcosis in a Moroccan boy: a silent and neglected disease among refugee and migrant children. BMJ Case Rep 2022; 15:e246399. [PMID: 35110281 PMCID: PMC8811558 DOI: 10.1136/bcr-2021-246399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2021] [Indexed: 11/03/2022] Open
Abstract
We report the unusual case of a 5-year-old migrant boy from a rural area of Morocco with an almost-giant lung hydatid cyst that was an incidental finding on a chest X-ray performed during routine visa procedures. Echinococcus granulosus serology test was initially negative with subsequent positive seroconversion. Albendazole was started at 4 weeks before surgery and maintained for 4 months, with a favourable outcome. Cystic echinococcosis (CE) is considered a neglected tropical disease and affects more than one million people worldwide, mostly from a lower socioeconomic background. Preventive measures have been limited in underdeveloped regions. Children with CE are especially vulnerable, due not only to the high pathogenic potential of the disease but also to their frequent involvement in challenging socioeconomic situations, including migration. The incidence of CE is increasing in Europe because of high immigration flows from endemic countries. Nevertheless, CE is not covered by current migrant screening protocols.
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Affiliation(s)
| | - Juan Luis Santos-Pérez
- Paediatrics, Paediatric Infectious Diseases and Immunology Unit, Hospital Universitario Virgen de las Nieves, Granada, Andalucía, Spain
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Sheikhy K, Rouhani R, Pejhan S, Sanei Motlagh A, Sheikhy A. Evaluation of clinical status, diagnosis, treatment and radiological findings of pulmonary hydatid cyst: 5-years' experience at tertiary lung center. CASPIAN JOURNAL OF INTERNAL MEDICINE 2022; 13:44-50. [PMID: 35178207 PMCID: PMC8797812 DOI: 10.22088/cjim.13.1.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/31/2020] [Accepted: 02/27/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Hydatidosis is one of the most critical worldwide parasitic zoonotic diseases. The lung is the second most common site of hydatidosis. This study aimed to evaluate the clinical status, diagnosis, treatment, and radiological findings of pulmonary hydatid cyst in patients referred to tertiary lung center. METHODS From April 2014 to July 2019, patients referred to Masih Daneshvari University Medical Center with the impression of alveolar hydatidosis included. Demographic data of 304 patients were collected including clinical symptoms, laboratory studies, radiological findings, location of the lung involvement, and cyst characteristics. Also, surgical procedures, medical treatments, and post-operative complications were recorded. RESULTS Pulmonary hydatidosis was confirmed for 234 patients. 55% of patients were males with the mean age of 45.1±16.6 years. The most common symptoms were cough (59.8%), dyspnea (31.1%), and hemoptysis (26%). Left lung, right lung, and bilateral involvement were reported in 40.1%, 55.1%, and 4.8% of cases, respectively. Cyst perforation (39.8%) was the most common intra-operative finding. Surgical interventions included thoracotomy, rigid bronchoscopy, cyst aspiration, and enucleation. The liver was the most concomitant organ involved due to pulmonary hydatidosis (16.6%). The most common postoperative complication was atelectasis, with the rate of 35.7%. 52.2% of patients were discharged within 10 days after surgery. No mortality was reported. CONCLUSION Sometimes atypical findings in different imaging modalities make the hydatid cyst diagnosis challenging. Although lobe involvement more than 50% has the indication for lobectomy, we conserved lobes with about 70% involvement in our institution, and patients had no postoperative complications.
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Affiliation(s)
- Kambiz Sheikhy
- Lung transplant Research Center (LTRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ramin Rouhani
- Department of General Surgery, Mazandaran University of Medical Sciences, Sari, Iran,Correspondence: Ramin Rouhani, Department of General Surgery, Mazandaran University of Medical Sciences, Sari, Iran. E-mail: , Tel: 0098 1133356329, Fax: 0098 1133356329
| | - Saviz Pejhan
- Lung transplant Research Center (LTRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ali Sheikhy
- Tehran University of Medical Sciences, Tehran, Iran
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Hill A, Guillén M, Martin D, Dreyfuss A. Point-of-care Ultrasound Diagnosis of Pulmonary Hydatid Cyst Disease Causing Shock: A Case Report. Clin Pract Cases Emerg Med 2021; 5:403-406. [PMID: 34813429 PMCID: PMC8610475 DOI: 10.5811/cpcem.2021.5.52264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/28/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Point-of-care ultrasound (POCUS) is accepted as an important tool for evaluating patients presenting to the emergency department (ED) with dyspnea1 and undifferentiated shock.2 Identifying the etiology and type of shock is time-critical since treatments vary based on this information. Clinicians typically rely on the history, exam, and diagnostics tests to identify the etiology of shock. In resource-limited settings where there is reduced access to timely laboratory and diagnostic studies. The use of POCUS enables rapid classification and directed treatment of shock. Additionally, POCUS can aid in the diagnosis of rarer tropical diseases that can be important causes of shock in resource-limited settings. Case Report We discuss a case of a pediatric patient who presented to an ED in Cusco, Peru, with acute dyspnea and shock. Point-of-care ultrasound was used to expedite the diagnosis of a ruptured pulmonary hydatid cyst, guide proper management of septic and anaphylactic shock, and expedite definitive surgical intervention. Conclusion In resource-limited settings where there is reduced access to timely laboratory and diagnostic studies, the use of POCUS enables rapid classification and directed treatment of shock.
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Affiliation(s)
- Alexandra Hill
- Highland Hospital - Alameda Health System, Department of Emergency Medicine, Oakland, California
| | - Marco Guillén
- Hospital Nacional Adolfo Guevara Velasco, Department of Emergency Medicine, Cusco, Peru
| | - David Martin
- Highland Hospital - Alameda Health System, Department of Emergency Medicine, Oakland, California
| | - Andrea Dreyfuss
- Highland Hospital - Alameda Health System, Department of Emergency Medicine, Oakland, California
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Yu XK, Zhang L, Ma WJ, Bi WZ, Ju SG. An Overview of Hepatic Echinococcosis and the Characteristic CT and MRI Imaging Manifestations. Infect Drug Resist 2021; 14:4447-4455. [PMID: 34737585 PMCID: PMC8558428 DOI: 10.2147/idr.s331957] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 09/30/2021] [Indexed: 11/25/2022] Open
Abstract
Hepatic echinococcosis is a parasitic, infectious disease with a high incidence in pastoral areas. It is highly infectious with a poor prognosis in some cases, which seriously affects the quality of life for people living in pastoral areas. This study aims to discuss the radiological characteristics, including computed tomography (CT) and magnetic resonance imaging (MRI), of hepatic echinococcosis from its definition, transmission, and pathological physiology. The characteristics of CT and MRI manifestations of cystic echinococcosis and alveolar echinococcosis are summarized in this study. It might help doctors to investigate this disease further and accurately make a diagnosis.
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Affiliation(s)
- Xiao-Kun Yu
- Department of Radiology, The Fifth Centre Hospital of Tianjin, Tianjin, 300450, People's Republic of China
| | - Le Zhang
- Department of Radiology, The Fifth Centre Hospital of Tianjin, Tianjin, 300450, People's Republic of China
| | - Wen-Jun Ma
- Department of Radiology, Huangnan Tibetan Autonomous Prefecture People's Hospital, Huangnan, Qinghai Province, 811300, People's Republic of China
| | - Wen-Zhong Bi
- Department of Radiology, Qinghai Tibetan Hospital, Xining, Qinghai Province, 810000, People's Republic of China
| | - Sheng-Gang Ju
- Department of Radiology, Henan Mongol Autonomous County People's Hospital, Xining, Qinghai Province, 811500, People's Republic of China
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Single-stage versus two-stage surgery of pulmonary and hepatic hydatid cysts. POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2021; 18:139-144. [PMID: 34703470 PMCID: PMC8525277 DOI: 10.5114/kitp.2021.109374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/01/2021] [Indexed: 11/26/2022]
Abstract
Introduction Concomitant lung and liver hydatid cyst is a rare condition. Most surgeons agree that both sites should be resected in one-time surgery. Aim We present a case series of hepatic and pulmonary hydatid cyst treated in one-stage surgery (OSS) compared with patients who underwent two-stage surgery (TSS). Material and methods This retrospective study included 47 patients separated into two groups (33 TSS and 14 OSS) between 2008 and 2019. Data on clinical symptoms, sites, radiological features, techniques, postoperative complications, mean hospital stay and outcome were analyzed separately for TSS and OSS procedures. Results A total of 33 patients who underwent TSS (70.2%) were compared to 14 patients operated on by OSS (29.8%). No significant differences were found between groups for age (45.3 vs. 42.7, p = 0.45), sex (male: 57.6% vs. 64.2%) and socio-geographic status (urban: 72.7% vs. 78.6%). But there were more postoperative complications (24.3% vs. 14.3%, p = 0.036) in the TSS group, and operative duration (154 minutes vs. 122 minutes, p = 0.047), postoperative hospital stay (13.8 days vs. 8.7 days, p = 0.022), and interruption of activities and work (56 days vs. 31 days, p = 0.045) were longer in the TSS group. There was no difference in postoperative mortality between the 2 groups. Conclusions Single-stage surgical management by trans-thoraco-phrenotomy can be recommended to treat dual-seat hepatic and pulmonary hydatid disease with fewer complications and a rapid return to work. This technique is easier and safer for right lung and liver dome hydatid cysts.
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38
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Arıbaş ET, Metin B, Dumanlı A, Arıbaş OK. Concomitant Occurrence of Hepatopulmonary hydatid Cysts in Turkey. IRANIAN JOURNAL OF PARASITOLOGY 2021; 16:506-511. [PMID: 34630597 PMCID: PMC8476728 DOI: 10.18502/ijpa.v16i3.7105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 04/11/2021] [Indexed: 11/24/2022]
Abstract
Background We aimed to report the demographic characteristics with diagnosis and treatment methods in patients with concomitant hepatopulmonary hydatid cysts. Methods Over a ten-year period (from 2002-2020) in Konya, Turkey, surgery was performed on 52 patients with hepatopulmonary hydatid cyst. Main outcome measure(s) were 52 hydatid cysts patients, which had cysts both in the liver and lungs, were investigated regarding their age, gender, cyst localization, suppuration, symptoms, and treatment methods. Results Seventeen of the patients were males. Their mean age was 39.7±18.8 years. The most common occupation was housewifery. The most common symptom was coughing and none of the patients with concomitant hepatopulmonary hydatid cysts was asymptomatic. The pulmonary hydatid cysts were mostly encountered in the right lung and the majority of the hepatic hydatid cysts were observed in the right lobe. The mean hospitalization time of the operated patients was 17.12±6.7 days. Conclusion In patients with hydatid cysts localized concomitantly in the right lung and subdiaphragmatic area, right thoracotomy for the pulmonary cyst and a transdiaphragmatic approach for the hepatic cyst is a safe, effective, and comfortable method.
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Affiliation(s)
- Emel Türk Arıbaş
- Department of Clinical Microbiology Infectious Diseases, Medical Faculty, Ufuk University, Ankara, Turkey
| | - Bayram Metin
- Department of Thoracic Surgery, Special Acıbadem Kayseri Hospital, Kayseri, Turkey
| | - Ahmet Dumanlı
- Department of Thoracic Surgery, Medical Faculty, Afyon Kocatepe University, Afyon, Turkey
| | - Olgun Kadir Arıbaş
- Department of Thoracic Surgery, Medical Faculty, Gazi University, Ankara, Turkey
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Khalfallah I, Hajjej S, Ferchichi M, Boussetta A, Affes M, Louhaichi S, Hamdi B, Ammar J, Hamzaoui A. Giant pulmonary hydatid cyst in children. Monaldi Arch Chest Dis 2021; 92. [PMID: 34523320 DOI: 10.4081/monaldi.2021.1770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/13/2021] [Indexed: 11/23/2022] Open
Abstract
Hydatid disease is still endemic in Tunisia. It is mostly seen in young people less than 40 years and children are affected in one third of cases. The lungs are the predominant location in children. Our study aims to define the particularities of children PHC's (pulmonary hydatic cyst) management, the characteristics of giant cyst and to study predictive factors of complications. We included retrospectively 105 children with PHC followed between 1999 and 2019. Patients were aged less than 16 years with surgically confirmed diagnosis of PHC. Two groups of cysts were defined: giant cysts which were 10 cm across or more, and no giant cysts.The sex-ratio was 1,38 with a mean age of 10.5±3 years. The symptomatology was dominated by cough (59%), thoracic pain (51%) and hemoptysis (46%). Giant cysts were observed in 24 (22.9%) patients. Dyspnea (29% vs 5% p<0.001) and thoracic pain (88% vs .41% p<0.001) were significantly more frequently reported in giant cysts. Eighty-six patients had a single cyst (83%) and 19 had multiple cysts (17%). Giant cysts accounted for 22,9% (24 cases). Thoracic ultrasonography was diagnostic in 77.4%. The thoracic CT scan was performed in 27 children with inaccessible cysts in thoracic ultrasonography or in diagnostic doubt.Patients were all treated surgically. Surgical procedures consisted of cystectomy (59%), pericystectomy (18%) and pulmonary resection when parenchyma was destroyed (23%). Parenchymal resection was more often performed in complicated cysts (27% vs 20% p>0.05) and in giant cysts (41% vs 18% p<0.05). A two-stage thoracotomy was performed in the 4 patients with bilateral cysts. Thirteen patients presented immediate post-operative complications which occurred more frequently in complicated and giant cysts. Hospital stay was longer in complicated cysts (16±9 days vs 7±3 days; p<0.001) and in giant cysts (14±9 days vs 11±8 days; p>0.05). In endemic regions, the diagnosis of PHC in children should be based on the combination of thoracic radiography and ultrasonography which are effective, not costly, safe and accessible. Complicated and giant PHC cause lung damage leading to extensive parenchymal resection. They are more associated with post-operative complications prolonging hospital stay and increasing expenses.
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Affiliation(s)
- Ikbel Khalfallah
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Sabri Hajjej
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Meriem Ferchichi
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Abir Boussetta
- Faculty of Medicine, El Manar University, Tunis; Pediatric Department, Charles Nicolle Hospital, Tunis .
| | - Meriam Affes
- Faculty of Medicine, El Manar University, Tunis; Radiology Department, Abderrahmen Mami hospital, Ariana.
| | - Sabrine Louhaichi
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Besma Hamdi
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Jamel Ammar
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
| | - Agnès Hamzaoui
- Pulmonology B Department, Abderrahmen Mami Hospital, Ariana; Faculty of Medicine, El Manar University, Tunis.
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Kumar K, Mathew JL, Vaidya PC, Bal A, Gupta N, Singhal KK, Saxena AK, Singh M. Flexible Fibreoptic Bronchoscopy and Bronchoalveolar Lavage for Confirmation of Pulmonary Hydatid Disease in Children: A Case Series. J Trop Pediatr 2021; 67:6363600. [PMID: 34477211 DOI: 10.1093/tropej/fmaa099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Hydatid disease of the lungs is common in endemic regions. It can be suspected clinically by non-specific respiratory symptoms in children living in endemic regions, especially when they are close to sheep or dogs. Chest imaging X-ray or computed tomography may show characteristic cysts in some cases, but typical findings are absent in many children. Hydatid serology may contribute to the diagnosis, but does not have sufficient sensitivity for pulmonary cysts. Thus, there is no confirmatory diagnostic test, other than surgical excision and histopathologic examination. Hence, there is a need for more reliable diagnostic tests. We present a series of children, both with and without suspected pulmonary hydatid, wherein flexible fibreoptic bronchoscopy (FFOB) performed under conscious sedation, revealed hydatid membranes in the airways. Bronchoalveolar lavage (BAL) analysis revealed hydatid in most of them. Thus the diagnosis could be confirmed even before surgical excision of cysts was performed. We propose that FFOB with BAL could be useful to confirm the diagnosis of pulmonary hydatid in children. This will be particularly helpful in children without characteristic radiological or serological findings. To the best of our knowledge, this is a completely novel approach to the condition with potential to alter the diagnostic paradigm Lay summary Hydatid disease of the lungs is commonly encountered in endemic regions. However, there is no confirmatory diagnostic test for pulmonary hydatid cyst, other than surgical excision and histopathologic examination. Imaging including chest X-ray and computed tomography may not be typical, especially in complicated cysts and hydatid serology does not have a satisfactory sensitivity for diagnosing lung cysts. Thus, there is a need for more reliable diagnostic tests. We present a series of children, both with and without suspected pulmonary hydatid, wherein flexible fibreoptic bronchoscopy (FFOB) under conscious sedation, revealed hydatid membranes in the airways. Bronchoalveolar lavage (BAL) analysis confirmed hydatid in most of them. We propose FFOB with BAL as a useful diagnostic modality to confirm pulmonary hydatid in children, prior to surgical excision. To the best of our knowledge, this is a completely novel approach to the condition with potential to alter the diagnostic paradigm.
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Affiliation(s)
- Ketan Kumar
- Pediatric Pulmonology Unit, Department of Pediatrics, PGIMER, Chandigarh 160012, India
| | - Joseph L Mathew
- Pediatric Pulmonology Unit, Department of Pediatrics, PGIMER, Chandigarh 160012, India
| | - Pankaj C Vaidya
- Pediatric Pulmonology Unit, Department of Pediatrics, PGIMER, Chandigarh 160012, India
| | - Amanjit Bal
- Department of Histopathology, PGIMER, Chandigarh 160012, India
| | - Nalini Gupta
- Department of Cytology and Gynaecological Pathology, PGIMER, Chandigarh 160012, India
| | - Kamal K Singhal
- Pediatric Pulmonology Unit, Department of Pediatrics, PGIMER, Chandigarh 160012, India
| | | | - Meenu Singh
- Pediatric Pulmonology Unit, Department of Pediatrics, PGIMER, Chandigarh 160012, India
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Ünal E, Arslan S, Aghayeva G, Sarıkaya Y, Çiftçi T, Önder S, Akıncı D, Akhan O. Rare pulmonary tumors and carcinoma mimickers; experience from an interventional radiology unit with radiologic-pathologic correlation-A pictoral essay. Curr Med Imaging 2021; 17:1183-1190. [PMID: 33881972 DOI: 10.2174/1573405617666210420105624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 02/28/2021] [Accepted: 03/08/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although imaging findings along with patients' clinical history may give clue for the etiology of a pulmonary lesion, the differentiation of benign pulmonary lesions from lung cancer could be challenging. OBJECTIVE The aim of this review article was to increase the awareness of the carcinoma mimicking lung lesions. METHODS This paper was designed to illustrate rare pulmonary tumors and carcinoma mimickers with emphasis on radiologic-pathologic correlation. Pitfalls encountered on CT images and also false positivity of PET-CT scans were also presented. CONCLUSION Several benign pulmonary lesions may grow in size on follow-up and some may show pathologic FDG (18F-fluorodeoxyglucose) uptake, which makes them indistinguishable from lung carcinoma by imaging. In addition, some slow-growing malignant lesions, such as carcinoid, may be false-negative on PET/CT scans.
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Affiliation(s)
- Emre Ünal
- Hacettepe University, School of Medicine, Department of Radiology Ankara, Turkey
| | - Sevtap Arslan
- Hacettepe University, School of Medicine, Department of Radiology Ankara, Turkey
| | - Gulnar Aghayeva
- Hacettepe University, School of Medicine, Department of Radiology Ankara, Turkey
| | - Yasin Sarıkaya
- Department of Radiology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Türkmen Çiftçi
- Hacettepe University, School of Medicine, Department of Radiology Ankara, Turkey
| | - Sevgen Önder
- Hacettepe University, School of Medicine, Department of Pathology Ankara, Turkey
| | - Devrim Akıncı
- Hacettepe University, School of Medicine, Department of Radiology Ankara, Turkey
| | - Okan Akhan
- Hacettepe University, School of Medicine, Department of Radiology Ankara, Turkey
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A 27-Year-Old Man With Intermittent Chest Pain During the Last 4 Years. Chest 2021; 159:e209-e214. [PMID: 34022020 DOI: 10.1016/j.chest.2020.11.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/11/2020] [Accepted: 11/16/2020] [Indexed: 11/24/2022] Open
Abstract
CASE PRESENTATION A 27-year-old man from Eritrea presented to the ED complaining about a progressively worse blunt chest pain in the anterior right hemithorax. Chest pain started 4 years ago and was intermittent. During the last 6 months, symptoms got worse, and the patient experienced shortness of breath in mild exercise. For this purpose, he visited another institution, where a chest radiograph was performed (Fig 1). He was advised to visit a pulmonologist for further evaluation, with the diagnosis of a loculated pleural effusion in the right upper hemithorax.
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Sioutis S, Reppas L, Bekos A, Soulioti E, Saranteas T, Koulalis D, Sapkas G, Mavrogenis AF. Echinococcosis of the spine. EFORT Open Rev 2021; 6:288-296. [PMID: 34040806 PMCID: PMC8142696 DOI: 10.1302/2058-5241.6.200130] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Echinococcosis or hydatid disease affecting the spine is an uncommon manifestation of Echinococcus granulosus infection of the spine.More commonly found in endemic areas, it causes significant morbidity and mortality as it grows slowly and produces symptoms mainly by compressing the spinal cord.As diagnostic methods are non-specific, diagnosis and management are usually delayed until the disease is advanced, thereby therapy is usually unlikely.Treatment is usually surgical, aiming at cyst excision, spinal cord decompression and spinal stabilization.This article summarizes the clinical findings of echinococcosis of the spine, discusses the specific laboratory and diagnostic findings, lists the current treatment options, and reviews the patients' outcomes.The aim is to prompt clinicians to be aware of the possibility of echinococcosis as a possible diagnosis in endemic areas. Cite this article: EFORT Open Rev 2021;6:288-296. DOI: 10.1302/2058-5241.6.200130.
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Affiliation(s)
- Spyridon Sioutis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Lampros Reppas
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Achilles Bekos
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Eleftheria Soulioti
- Second Department of Anaesthesiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Theodosis Saranteas
- Second Department of Anaesthesiology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios Koulalis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Georgios Sapkas
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Andreas F. Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Pulmonary Hydatid Cyst Diagnosed by Flexible Fiberoptic Bronchoscopy. J Bronchology Interv Pulmonol 2021; 28:150-152. [PMID: 33753704 DOI: 10.1097/lbr.0000000000000742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 11/17/2020] [Indexed: 11/26/2022]
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The spectrum of imaging findings in pulmonary hydatid disease and the additive value of T2-weighted magnetic resonance imaging in its diagnosis. Pol J Radiol 2021; 86:e53-e63. [PMID: 33708273 PMCID: PMC7934737 DOI: 10.5114/pjr.2021.103237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/15/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose To describe the spectrum of imaging findings in pulmonary echinococcosis and to study the additive value of T2-weighted magnetic resonance imaging (MRI) in the characterisation of pulmonary hydatid disease. Material and methods This was a descriptive, prospective study conducted for a period of 3 years from December 2016 to November 2019. Patients suspected of having pulmonary echinococcosis (n = 110) on preliminary chest radiography were examined with chest computed tomography (CT). Among them 41 cases were additionally examined with T2-weighted MRI of thorax. Final diagnosis was based on surgery or histopathology. Results Of the 110 patients enrolled for the study 15 were lost to attrition, and among the final cohort of 95 patients CT correctly diagnosed 68/84 (80.9%) as hydatid cyst, whereas 16/84 (19.1%) received an erroneous alternate diagnosis on CT. Based on the classical findings of hyperintense pulmonary cystic lesion with T2-weighted hypointense rim or detached internal T2-weighted hypointense membrane, a correct diagnosis of hydatid cyst was possible in 30 patients whereas a correct alternate diagnosis was made in 8 cases. T2-weighted MRI was found to have sensitivity of 96.7%, specificity of 80%, positive predictive value (PPV) of 93.7% and negative predictive value (NPV) of 88.9% with an overall diagnostic accuracy of 92.6%. Using the McNemar test, MRI was found to be diagnostically superior to CT (p = 0.019). Conclusions Most of the pulmonary hydatid cysts can be diagnosed on CT; however, sometimes the findings may be indeterminate or atypical, leading to a diagnostic dilemma. MRI, owing to its ability to demonstrate hypointense endocyst, can act as a useful adjunct to correctly diagnose hydatid cyst or suggest an alternative diagnosis.
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Chatterjee A, Sen Dutt T, Ghosh P, Mukhopadhyay S, Chandra A, Sen S. Inflammatory Lesions Mimicking Chest Malignancy: CT, Bronchoscopy, EBUS, and PET Evaluation From an Oncology Referral Center. Curr Probl Diagn Radiol 2021; 51:235-249. [PMID: 33483189 DOI: 10.1067/j.cpradiol.2020.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 12/19/2020] [Accepted: 12/31/2020] [Indexed: 11/22/2022]
Abstract
Infective and inflammatory diseases can mimic malignancy of the lung. Granulomatous inflammations are common causes of pulmonary nodule, mass, or nodal disease. Systemic infection or inflammation also commonly involves the lung that may raise suspicion of a malignant process. Even in patients with a known malignancy, inflammatory diseases can simulate new metastasis or disease progression. Knowledge of the imaging features of these diseases is essential to prevent missed or overdiagnosis of malignancy. Radiologists also need to be familiar with the scope and limitations of bronchoscopy, endobronchial ultrasound, PET-CT, and biopsy to guide clinical management. In this review, we discuss the imaging features and diagnostic approach of common mimickers of chest malignancy that involve the chest wall, pleura, lung parenchyma, and mediastinal nodes.
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Affiliation(s)
- Argha Chatterjee
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India.
| | - Tiyas Sen Dutt
- Department of Pulmonology, Tata Medical Center, Kolkata, West Bengal, India
| | - Priya Ghosh
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Sumit Mukhopadhyay
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Aditi Chandra
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
| | - Saugata Sen
- Department of Radiology and Imaging, Tata Medical Center, Kolkata, West Bengal, India
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Durhan G, Tan AA, Düzgün SA, Akkaya S, Arıyürek OM. Radiological manifestations of thoracic hydatid cysts: pulmonary and extrapulmonary findings. Insights Imaging 2020; 11:116. [PMID: 33175295 PMCID: PMC7658283 DOI: 10.1186/s13244-020-00916-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/30/2020] [Indexed: 11/27/2022] Open
Abstract
Hydatid cyst caused by the larval form of Echinococcus is a worldwide zoonosis. The lungs and liver are the most common sites involved. While the lung parenchyma is the most common site within the thorax, it may develop in any extrapulmonary region including the pleural cavity, fissures, mediastinum, heart, vascular structures, chest wall, and diaphragm. Imaging plays a pivotal role not only in the diagnosis of hydatid cyst, but also in the visualization of the extent of involvement and complications. The aim of this pictorial review was to comprehensively describe the imaging findings of thoracic hydatid cyst including pulmonary and very unusual extrapulmonary involvements. An outline is also given for the findings of complications and differential diagnosis of thoracic hydatid cyst.
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