Complicated pulmonary hydatid cyst

Case contributed by Pradosh Kumar Sarangi
Diagnosis almost certain

Presentation

Chest pain, cough for six months.No history of fever, hemoptysis. No past history of tuberculosis.

Patient Data

Age: 25 years
Gender: Male
Coronal
scannogram
This study is a stack
Axial lung
window
This study is a stack
Coronal
lung window
This study is a stack
Sagittal
lung window
This study is a stack
Axial non-contrast
supine
This study is a stack
Axial non-contrast
prone
This study is a stack
Coronal
non-contrast
This study is a stack
Sagittal
non-contrast
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Info

Air-filled cavitary lesion of approximate size 8 cm x 7 cm in right middle lobe containing membrane-like structures noted. The cavity communicates with a bronchus. Internal structures of the cavity shifts between supine and prone position. Tree in bud sign is seen in the right lower lobe, left upper and lower lobe.

Case Discussion

Air filled cavitary lesion with internal membranous structures noted in right middle lobe. Membranous structures moved anteriorly on prone position.There is communication of the cavity with a bronchus. Right lower lobe and left lung field show tree-in-bud sign suggestive of endobronchial spread (rupture of cyst into bronchus).

Patient had peripheral eosinophilia and positive IgG echinococcal antibody.

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