Pleural hydatid cysts

Case contributed by Dr Karwan Taha

Presentation

Long history of left loin pain, no history of dyspnoea, cough or fever.

Patient Data

Age: 25 years
Gender: Female
X-ray

A well-defined round shaped pleural based mass lesion is seen in the left side of the chest, It shows homogeneous opacity with smooth margins and no matrix of calcification detected, the findings are in favour of hydatid cyst (CT chest with contrast was recommended).

CT
  • A well-defined oval shaped large intra-pleural cystic lesion with numerous daughter cysts inside is seen in the left side of the chest. It showed fluid CT density, smooth margin, hypodense content relative to the capsule with a thin enhancing capsule, picture highly in favour of an uncomplicated pleural hydatid cyst.
  • Both lungs clear with normal pulmonary vascular markings, no focal lesion.
  • Normal mediastinum with normal mediastinal vasculature, no mass or enlarged LN.
Photo

Operative findings

The patient underwent thoracotomy and the findings of numerous cystic lesions within the pleura confirming the diagnosis of hydatid cysts.

Case presented with permission, courtesy of Dr. Chalak (Cardiothoracic surgeon).

X-ray

24 hours post operative chest X-ray

Left lung shows haziness in lower zone with blunting of left costophrenic angle secondary to pleural effusion. Right lung clear and right costophrenic angle within normal limits. Both hilum normal in size and density. Drainage tube is seen in left side of the chest wall.

Case Discussion

Hydatid cysts result from infection by the Echinococcus worm, and can result in cyst formation anywhere in the body. 

Primary pleural hydatid cyst is an uncommon mode of presentation of hydatid disease.

It is important to keep hydatid disease in mind as one of the rare but possible differential diagnosis in cystic lesions of the chest wall in the endemic zones. Blind aspiration should be avoided.

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Case information

rID: 56784
Case created: 21st Nov 2017
Last edited: 29th Nov 2017
System: Chest
Inclusion in quiz mode: Included

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