New diagnostic signs in hydatid disease; radiography, ultrasound, CT and MRI correlated to pathology

Sinner, W

doi:10.1016/0720-048x(91)90119-g

Cited by 155 publications

(102 citation statements)

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“…Thoracic hydatid cysts are diagnosed on the basis of radiological findings [14,15]. As a result of pleural complications, the diagnosis could be incorrect, and eliminating hydatid cyst as a diagnosis may be difficult.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Pulmonary Hydatid Cysts, Which Perforated to the Pleura

Sayır¹,

Çobanoğlu²,

Şehitoğulları³

2012

EAJM

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Objective: Hydatid cyst disease, endemic in Eastern region of Turkey, is a significant parasitic public health problem. In this study, pleural complications of hydatid cysts were presented in 76 cases. Materials and Methods:In our study, of the 412 pulmonary hydatid cyst cases operated on between 2003 and 2011, 76 cases had ruptured into the pleura for various reasons, and the different clinicoradiological presentations were evaluated retrospectively. The age distribution of the cases was between 7 and 56 years, and the mean age was 26.20±13.04. Results:The most frequent symptom due to pleural rupture in patients was dyspnea (44 cases, 57.8%). Etiologically, iatrogenic perforation was detected in four cases and thoracic trauma in nine cases (six car accidents and three falls from a height). An anthelmintic drug use history was found in three cases of ruptured pleura. Spontaneous perforation was detected in the other 60 (78.9%) cases. Two cases that were admitted to the emergency unit and were immediately administered a tube thoracostomy developed tension pneumothorax. In addition, 21 cases had hydropneumothorax, 17 had pneumothorax, and 36 had pleurisy. Morbidity was observed in 30 cases (39.4%). Atelectasis was the most frequent cause of morbidity in these patients (10 cases). The mean duration of hospitalization was determined to be 12.26±2.90 days. Conclusion:This disease can progress asymptomatically for a long time and can sometimes lead to life-threatening emergency situations, such as tension pneumothorax. The delayed admission of a patient to a physician causes the disease to become more complicated and to increase the morbidity and mortality rates. Treatment of the disease is in the form of surgery. Possible parenchymal protection should be applied in surgical treatment, and anatomic resection should not be performed unless necessary.Key Words: Empyema, Capitonnage, Pleura, Rupture Özet Amaç: Kist hidatik hastalığı, yöremizin ve ülkemizin endemik olarak görülen önemli bir paraziter-halk sağlığı sorunudur. Kist hidatik hastalığı, asemptomatik olarak seyredebildiği gibi, tansiyon pnömo-toraks gibi hayatiyet arzeden önemli komplikasyonlarla da kendini gösterebilir. Çalışmamızda kist hidatiğin plevral komplikasyonları 76 olgu temelinde sunulmuştur. Gereç ve Yöntem:2003-2011 yılları arasında opere edilen 412 akciğer kist hidatikli olgudan, plevraya çeşitli nedenlerle ve değişik klinikradyolojik presentasyonlarla rüptüre olan 76 olgu retrospektif olarak değerlendirildi. Olguların 42'si erkek, 34'ü kadındı. Olguların yaş dağılımı 7-56 arasında ve ortalama yaş 26.20±13.04 olarak belirlendi. Bulgular:Plevral rüptür nedeniyle olgularda en sık gözlenen semptom dispne oldu (44 olgu, %57.8). Etyolojide 4 olguda iatrojenik perforasyon, 9 olguda toraks travması (6 olgu araç içi trafik kazası, 3 olguda yüksekten düşme) tesbit edildi. Plevraya rüptüre 3 olguda daha önceden antihelmintik ilaç alımı söz konusuydu. Diğer 60 (%78.9) olguda spontan perforasyon tesbit edildi. Acil ünitesine başvuran ve derhal tüp tora...

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Pulmonary Hydatid Cysts, Which Perforated to the Pleura

Sayır¹,

Çobanoğlu²,

Şehitoğulları³

2012

EAJM

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“…That is emphasized by the facts that no serological test is highly specifi c for hydatid cyst in humans. Lack of protoscolex in aspirated fl uid does not rule out the diagnosis [4]. The sensitivity of serological test is low especially in the cases of extrahepatic hydatidosis (only 50%) [5].…”

Section: Discussionmentioning

confidence: 99%

Hydatid cyst in submandibular salivary gland

Pal

Shankar

2008

Indian J Otolaryngol Head Neck S

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This case of 52-year male with swelling in the left submandibular area for 1 year came to ENT OPD of Patna medical college, Patna. Clinical examination showed swelling to be multiple nontender cysts with enlarged submandibular salivary gland. CT-scan revealed large well-defi ned encapsulated multicystic lesions in the left submandibular gland. FNAC was suggestive of aspirate to be ectopic to that area. Excision biopsy was done. HPE showed features suggestive of parasitic infestation along with chronic sialadenitis. Gross picture and investigations were highly suggestive of parasitic infestation to be primary hydatid cyst of the gland. Scanning for other areas like liver and lungs done, no lesion was found.

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“…It is especially helpful in abdominal hydatid cysts [10] specifically if a "double-line" sign is present (Figure 4), demonstrating parasitic membranes of a hydatid cyst [1,2,5] and if brood capsules or daughter cysts are demonstrated. However, ultrasonography is of limited value in lung echinococcosis unless an acoustic window is available, such as occurs if the cyst is located in the vicinity of the thoracic wall or contiguous to an effusion.…”

Section: Discussionmentioning

confidence: 99%

“…However, the presence of characteristic or diagnostic findings such as a low signal intensity rim on T2 weighted images representing the cyst wall, cyst rupture and "folded parasitic membranes" called "serpent sign" [1][2][3]5] has only most recently been described. If present, it may allow a confident diagnosis of hydatid disease in some cases even if serologic tests should be falsely negative [1][2][3].…”

Section: Discussionmentioning

confidence: 99%

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Hydatidosis Mimicking Metastases

1992

Ann Saudi Med

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WN von Sinner, Hydatidosis Mimicking Metastases. 1992; 12(3): 316-320 In three cases hydatid cysts were initially misdiagnosed as metastases. A case of biopsy-confirmed hypernephroma showed multiple bilateral rounded densities in the lungs suggesting metastatic disease. A second case with cystic expansive lesion of the liver clinically diagnosed as "cystic hepatocellular carcinoma" was combined with multiple bilateral "nodules" of the lungs mimicking metastases. A third case with biopsy-confirmed hypernephroma demonstrated multiple hepatic lesions thought to be metastases. Computed tomography (CT) was helpful in disclosing these low density lesions as hydatidoses.The recognition of a malignant tumor coexistent with hydatid disease is important for appropriate and effective treatment both of the malignant tumor and the parasitic infection. Today, powerful benzimidazole compounds make successful chemotherapy treatment feasible even in widespread or disseminated hydatid disease. Recognition of these lesions is, therefore, crucial for potential cure.Ultrasonography (US) computed tomography (CT), and magnetic resonance imaging (MRI) have, to a large extent, replaced less effective and invasive methods. Alone or in combination with each other, they are helpful in assessing uni-or multilocular lesions throughout the body, including the lungs [1][2][3][4][5]. Hydatidosis and tumor may look very similar [6,7]. In cases where extrapulmonary malignant tumor has been confirmed by biopsy, the occurrence of multiple rounded densities in the lungs are usually interpreted as metastases. Even without a known primary tumor, multiple hydatid cysts in other organs or tissues may closely resemble neoplastic deposits and be confused with metastases. Their recognition is, therefore, extremely important for appropriate therapeutic management as a precondition for cure [8]. Case Reports Case 1In a 51-year-old man, a space-occupying lesion of the left kidney was discovered. A CT of the abdomen and kidneys (Figure la) confirmed the presence of a 13 cm in diameter large mass of the left kidney with irregular density and a tiny area of calcification. No evidence of lymphadenopathy or extrarenal extension was found. A fine needle aspiration biopsy revealed a renal cell carcinoma. On the preoperative chest radiography, two rounded bilateral densities in the lower lobes were seen (right 2.5 cm and left 6 cm in diameter) thought to be metastases. It was therefore assumed that the patient was inoperable. CT of the chest, however, showed that the lesions were cystic. Since the density was between 10 and 20 HU, infected cysts or hydatid disease (Figure lb) could not be excluded. Serological examinations revealed very high echinococcal titers (IHA 1:2, 048; normal values up to 1:32) confirming the presence of hydatid disease. A radical left nephrectomy was, therefore, still possible and carried out before renal metastases had developed. Case 2A 46-year-old man suffered from shortness of breath for three years, weight loss and cough. In the past...

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New diagnostic signs in hydatid disease; radiography, ultrasound, CT and MRI correlated to pathology

Cited by 155 publications

References 35 publications

Surgical Treatment of Pulmonary Hydatid Cysts, Which Perforated to the Pleura

Surgical Treatment of Pulmonary Hydatid Cysts, Which Perforated to the Pleura

Hydatid cyst in submandibular salivary gland

Hydatidosis Mimicking Metastases

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