Pulmonary embolism due to cardiac hydatid disease: imaging findings of unusual complication of hydatid cyst

Ödev, Kemal; Açıkgözoğlu, Saim; Görmüş, Niyazi; Aribas, Olgun Kadir; Da, Kiresi; Solak, Hasan

doi:10.1007/s003300100988

Cited by 34 publications

(32 citation statements)

References 14 publications

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“…The embryo rarely reaches the right heart cavities through the portal or lymphatic routes. Hydatic PE occurs after rupture of a hydatid cyst in the right ventricle or atrium, or more rarely haematogenous dissemination from a hepatic focus rupturing into the hepatic veins or the inferior vena cava [200,201]. Autopsy findings indicate that embolism is caused by vesicles or cysts that act purely mechanically by obstructing the blood flow, as there are no blood clots or added thrombosis [202].…”

Section: Pathophysiologymentioning

confidence: 99%

“…Autopsy findings indicate that embolism is caused by vesicles or cysts that act purely mechanically by obstructing the blood flow, as there are no blood clots or added thrombosis [202]. Hydatid cysts may rarely present in the wall of the arteries [200,201].…”

Section: Pathophysiologymentioning

confidence: 99%

“…The major complication is rupture of the cyst into the pericardium, which can lead to anaphylactic shock or tamponade [200]. The clinical manifestations of pulmonary arterial hydatid cyst embolisation are not specific, although haemoptysis is the most frequent sign [203,204].…”

Section: Clinical Signsmentioning

confidence: 99%

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Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

Eur Respir J

162

127

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Nonthrombotic pulmonary embolism (NTPE) is defined as embolisation to the pulmonary circulation of different cell types (adipocytes, haematopoietic, amniotic, trophoblastic or tumour), bacteria, fungi, foreign material or gas. The purpose of this article is to describe the clinical signs, pathogenesis, diagnosis and treatment of the different NTPE subtypes.The complex and diverse pathogenesis of different subtypes of emboli is subject to continuing speculation and is certainly far more complex than ''simple'' mechanical obstruction after embolisation of vascular thrombi. Nonthrombotic emboli may also lead to a severe inflammatory reaction both in the systemic and pulmonary circulation, as well as in the lung.NTPE presents a formidable diagnostic challenge, as the condition often presents with very unusual and peculiar clinical signs that are frequently overlooked. They range from very dramatic acute presentations such as acute respiratory distress syndrome to signs observed late in the disease course. Pathological observations play a key role in the exact diagnosis, and sometimes carefully aspirated blood from the pulmonary artery or specific staining of cells recovered from bronchoalveolar lavage fluid may be helpful. Frequently, lung biopsies revealing severe granulomatous reaction or unfortunate post-mortem pathological investigations of pulmonary tissue are necessary to confirm the diagnosis. Here, we also aim to familiarise the reader with the atypical radiological features of NTPE. Thin-section computed tomography of the lungs showing peculiar radiographic findings, such as a feeding vessel, the so-called tree-in-bud pattern or the appearance of micronodules distributed at the termination of bronchovascular bundles, may be observed in certain forms of NTPE.Increased awareness of NTPE as an underestimated cause of acute and chronic embolism, which may result in acute and chronic pulmonary hypertension, is needed. Despite the fact that detailed descriptions of several forms of NTPE have existed for nearly 100 years, well-designed trials have never been performed to evaluate therapy in the different subsets of these patients.

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Section: Pathophysiologymentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

See 1 more Smart Citation

Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

Eur Respir J

162

127

View full text Add to dashboard Cite

show abstract

“…Pulmonary cyst embolization is thought to be caused by rupture of visceral cysts and migration of daughter vesicles through venous circulation or by rupture of cardiac cysts in the right ventricle. [8] An extraordinary finding seen in our case is that, despite the widespread embolism of the pulmonary artery, there was no evidence of pulmonary arterial hypertension. The rupture of cysts in micro-cysts resulting in pulmonary artery embolization may explain this mechanism.…”

Section: Discussionmentioning

confidence: 46%

“…Occasionally, patients are lost secondary to anaphylactic shock, cardiac tamponade, and systemic or pulmonary embolization. The most life-threatening complication of cardiac hydatid cyst is perforation and with a reported intra-cardiac perforation frequency of 25 to 40%, [6][7][8][9][10] After cyst perforation, three quarters of the patients die from embolic complications.…”

Section: Discussionmentioning

confidence: 99%