Pulmonary paragonimiasis

Pulmonary paragonimiasis is a food-borne parasitic disease caused by the lung fluke (trematode) Paragonimus westermani. It is endemic in southeast asia, the the far east, and is also relatively common latin america and Africa 1-2. The disease affect can both the lung and pleura 3 although lung parechymal involvement is thought to be commoner than plerual involvement 2.

Radiographic features

CT chest: HRCT

It usually manifests as a poorly marginated subpleural or subfissural nodule of about 2 cm in diameter that frequently contains a necrotic low-attenuation area 2. The constellation of focal pleural thickening and subpleural linear opacities leading to a necrotic peripheral pulmonary nodule is another frequent CT finding.

There also a myriad of other associated non specific features. These can vary with the stage of disease.

Early findings are thought to be caused by the migration of juvenile worms and include:

Later findings are thought to caused by worm cysts and include:

Differential diagnosis

Imaging features can sometimes mimic that of lung cancer or pulmonary tuberculosis 2.

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Article information

rID: 19324
System: Chest
Tag: cases
Synonyms or Alternate Spellings:
  • Lung paragonimiasis
  • Paragonimiasis of lung
  • Paragonimiasis of the lung
  • Pleuropulmonary paragonimiasis

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