Pulmonology Procedures |

Bronchoscopic Diagnosis and Complete Treatment of a Ruptured Left Pulmonary Hydatid Cyst FREE TO VIEW

Oana Arghir*, PhD; Elena Dantes, PhD; Claudia Toma, PhD; Mihai Alexe, PhD
Author and Funding Information

Constanta Clinical Pulmonology Hospital, Constanta, Romania

Chest. 2012;142(4_MeetingAbstracts):880A. doi:10.1378/chest.1388853
Text Size: A A A
Published online


SESSION TYPE: Bronchology Global Case Report Posters

PRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PM

INTRODUCTION: Hydatid disease is not an endemic disease in Romania. Hydatid cyst disease is caused by Echinococcosis granulosus from cestods. Pulmonary hydatid cyst is the second most frequent form of the disease after the liver involvement and, rarely, may be atypical and misdiagnosed.

CASE PRESENTATION: We present a case of 27 year-old white man, smoker (7.5 package-years), with a four months history of chronic cough, left chest pain and sweats, who was addmited in our hospital for recurrent hemoptysis. Chest film revealed in the upper left lobe an atypical ovalar homogenous, ill-defined nodular lesion, mimicking a tumoral process in the upper lobe. He had history of close contact with dogs in the previous 12 years. Fiberoptic bronchoscopy reevaluation, performed in Marius Nasta Pneumology Institute, confirmed the definitive diagnosis as ruptured pulmonary hydatidosis by revealing a white gelatinous membrane- like structure protruding from the subsegmentary bronchus of apicoposterior segmental bronchi of the left upper lobe, which was totally removed by aspiration. A control thoracic CT-scan was performed and revealed a small residual cavity in the left upper lobe with a bronchial dilatation. Hydatid serology was positive. Abdominal ultrasonography was normal, with no evidence of hydatid cysts in the liver. The young adult did not require thoracic surgery and made a full clinical and stable recovery under therapy with Albendazole. After 2 years, his chest film is normal.

DISCUSSION: Humans may contract the disease by ingestion of eggs from contaminated water, food or from close contact with dogs. Pulmonary hydatid cysts are often asymptomatic and can be, incidentally, diagnosed on plain chest radiographs but CT is the preferred imaging exam.[1] Several cases of pulmonary hydatic cyst opened into the bronchial tree by perforation were described, mostly, in endemic areas, such as Turkey.[2] When a hidatid pulmonary cyst ruptures into the bronchus, the radiologic pattern of the disease may mimic several diseases, such as nodular pulmonary tuberculosis, round pneumonia, lung abscess or, even, tumour of the lungs. [3] Few articles have described the impact of bronchoscopic management of parenchymal lung hydatid cysts complicated by endobronchial involvement in children and adults. Treatment of pulmonary hydatid cyst by endoscopy is an exceptional event.

CONCLUSIONS: Our case illustrates an atypical clinical and radiological presentation of pulmonary hidatidosis complicated with rupture into bronchus. Flexible bronchoscopy is a valuable diagnostic procedure which may offer, in the same time, a complete and stable curative treatment.

1) Santivanez S, Garcia HH. Pulmonary cystic echinococcosis. Curr Opin Pulm Med 2010;16:257-61.

2) Kilinc O, Döskaya M, Sakar A, Yorgancioglu A, Halilçolar H, Caner A, Gürüz Y.- Three atypical pulmonary hydatidosis lesions mimicking bronchial cancer from Turkey. New Microbiol.2009 Apr;32(2):229-33.

3) Köksal D, Altinok T, Kocaman Y, Tastepe I, Ozkara S.- Bronchoscopic diagnosis of ruptured pulmonary hydatid cyst presenting as nonresolving pneumonia: report of two patients. Lung. 2004;182(6):363-8.

DISCLOSURE: The following authors have nothing to disclose: Oana Arghir, Elena Dantes, Claudia Toma, Mihai Alexe

No Product/Research Disclosure Information

Constanta Clinical Pulmonology Hospital, Constanta, Romania




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Simultaneous traumatic rupture of bilateral pulmonary hydatid cysts. J Thorac Cardiovasc Surg 2005;130(3):908-9.
[Traumatic rupture of a pulmonary hydatid cyst: a case report]. Ulus Travma Acil Cerrahi Derg 2006;12(1):71-5.
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543