A Case of Paragonimiasis Westermanii Complicated with Migrating Subcutaneous Induration and Multiple Involvements in the Liver

Takemasa, Hiroko; Saito, Kazuyoshi; Nakayamada, Shingo; Kanazawa, Tamotsu; Tanaka, Yoshiya

doi:10.11150/kansenshogakuzasshi1970.76.594

Cited by 10 publications

(6 citation statements)

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“…They found that the juvenile worms migrating into the abdominal cavity immediately entered the inner wall of the abdominal cavity. Several cases of early stage paragonimiasis have been reported; the authors described that they present as a subcutaneous induration or mass in the abdominal subcutaneous tissue (23-25). We observed subcutaneous air bubbles at day 30 in the subcutaneous tissues of the abdominal wall or chest wall on CT, and this has not been reported previously.…”

Section: Discussionmentioning

confidence: 99%

Serial CT Findings of Paragonimus Infested Dogs and the Micro-CT Findings of the Worm Cysts

Lee

Goo

et al. 2007

Korean J Radiol

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Objective: To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. Materials and Methods:This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. Results:The initial findings were pleural effusion and/or subpleural groundglass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. Conclusion:The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus.aragonimiasis is a food-borne disease, and it is caused by lung flukes (Paragonimus) of the genus Paragonimus. Among more than 45 species of lung flukes described from various parts of the world, only 12 of these species infect human (1). The most common and wide-spread species is P. westermani. Human cases of paragonimiasis have been reported mostly from Japan, Korea, Formosa, China, Manchuria, the Philippine Islands, India, parts of tropical West Africa and Latin America (2 15). An estimated 22 million people are infected worldwide with paragonimiasis (16).The radiographic and computed tomographic (CT) findings of patients with pleuropulmonary paragonimiasis have been reported on by several authors (5, 17 19). The CT findings of pleuropulmonary paragonimiasis are known to be subpleural or subfissural nodules that contain low-attenuation areas, and these nodules are accompanied with pleural thickening and subpleural linear opacities (18). The

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Section: Discussionmentioning

confidence: 99%

Serial CT Findings of Paragonimus Infested Dogs and the Micro-CT Findings of the Worm Cysts

Lee

Goo

et al. 2007

Korean J Radiol

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“…In the review of previously reported CT findings, hepatic paragonimiasis was commonly seen as multiple low attenuating lesions which might be scattered or clustered (3, 7, 13). In two case reports, it manifestated as a single, low attenuating lesion mimicking solid mass and mandated surgical resection (8, 9).…”

Section: Discussionmentioning

confidence: 99%

“…After ingested, juvenile worms of Paragonimus migrate to the lung via tortuous tracks (1). For this reason, although primary site of paragonimiasis is the lung, ectopic infestation can occur in unexpected sites such as the brain, subcutaneous tissue and muscles, omentum and mesentery, retroperitoneum, adrenal glands, ovary, epididymis and liver (1-13). …”

Section: Introductionmentioning

confidence: 99%

Imaging Findings of Hepatic Paragonimiasis: A Case Report

et al. 2004

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Hepatic paragonimiasis is a rare form of ectopic infestation caused by Paragonimus. We experienced a case of hepatic paragonimiasis that showed characteristic imaging findings. CT and MR images showed a cluster of small cysts with rim enhancement in the subcapsular area of the liver. This finding seems to be characteristic for hepatic paragonimiasis, considering imaging findings in paragonimiasis involving other organs.

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“…Several cases of early-stage PW have been reported that have presented as a subcutaneous induration or as a mass in the abdominal subcutaneous tissue [9,12]. Yokogawa [3] investigated the migratory route of juvenile PW in cats and rats.…”

Section: Discussionmentioning

confidence: 99%