Introduction and importance: The Echinococcus Granulosus, an endemic parasite in several parts of the world which causes hydatid disease. Human acts as an intermediate host and gets infected by eating parasitic eggs. As it is well known, lungs and liver are the most commonly involved organs in this disease. When the pleura is involved, it is almost always secondary to a ruptured primary lung cyst. Case presentation The purpose of this paper is to present a case of 16-year-old male with complaints of dyspnoea and dry cough for 6 months. His vital signs, CBC, and laboratory tests were all within normal. Chest X-ray showed a complete opacification of hemithorax. Clinical discussion CT revealed multiple cysts filling up the whole pleural cavity with collapsed lung and to-left mediastinal shift. The patient was diagnosed with primary pleural hydatidosis. The treatment was surgical, followed by parasitic medications. During the surgery, surgeons were able to simply extract many cysts by hand and eventually the collapsed lung returns to its normal volume and normal functional state. The patient was indicated to continue with Albendazole for 1 year after surgery. Three days after the surgery, chest X-ray was within normal. Conclusion Primary pleural hydatidosis is such a rare case to present as full filled up pleural cavity and a complete opacification of hemithorax on CXR. Using the developed technical methods helped to confirm such case and in choosing the best surgical intervention. The result was satisfactory with fully expanded and functional lung.
Introduction and importance: Congenital pulmonary airway malformation (CPAM), formerly known as congenital cystic adenomatoid malformation (CCAM), is a rare developmental dysplatic lesion of the fetal tracheobronchial tree. It accounts for approximately 25 % of all congenital lung malformations. It is usually unilateral and involves one lobe with no significant gender or racial predilection. The vast majority of reported CPAM cases were discovered prenatally or within the first 2 years of life; however, it is rarely found in older children and adults. Case presentation The purpose of this paper is to present a case of a 14-year-old male with a chest tube inserted 5 days before, as a management to left-sided spontaneous pneumothorax. His vital signs and laboratory tests were all within normal. Chest X-ray showed irregular opacity in the left lung field. Clinical discussion CT revealed multiple cystic-like lesions in the upper lobe of the left lung. The clinical impression was pointing towards a congenital lung lesion. The patient then underwent surgery. There were several pleural adhesions. The adhesions were released, and the upper left lobe was resected. Histopathological findings were compatible with type II CPAM. Four days postoperatively, chest X-ray was within the normal. Conclusion We report this case to highlight the importance of considering CPAM and other congenital malformations as a differential diagnosis in the adult population, especially in patients with sudden onset of pulmonary symptoms along with multiple cystic-like lesions on CT, as well as to draw attention towards spontaneous pneumothorax as a possible first presentation for CPAM.
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