Pulmonary hydatid cyst with co‐existent aspergillosis: A rare cytology finding

Abstract

Pulmonary hydatid cyst with co-existing aspergillosis is rare. Till date, there are only two documented reports of this double pathology being diagnosed on cytology. The present case is of a young immunocompetent female who presented with respiratory complaints including intermittent hemoptysis. Chest X-ray and CT thorax revealed two well-defined lesions in the lower lobe of left lung that was suggestive of either infective or benign neoplastic etiology. But as hydatid cyst was not suspected either clinically or radiologically, FNA was performed. Based on the typical cytomorphological features a definitive diagnosis of hydatid cyst with aspergillosis was offered on cytology that was later confirmed on histopathology. To the best of our knowledge this is only the third report of pulmonary echinococcosis with aspergillus co-infection being diagnosed on cytology. The purpose of reporting this case is to draw attention to the rare possibility of co-existing aspergillus infection in pulmonary echinococcosis even in immunocompetent individuals, which can complicate the clinico-radiological picture. However, both pathologies can be effectively and accurately diagnosed on cytology, based on which proper treatment can be initiated. Diagn. Cytopathol. 2016;44:696-699. © 2016 Wiley Periodicals, Inc.

Computed Tomography Guided Fine Needle Aspiration Cytology of Lung and Mediastinal Lesions

“…This case has already been published. 14 Table-3 shows the primary neoplastic lesions in lung. The most common primary lung malignant neoplasm was adenocarcinoma.…”

“…16 In the present case the atypical radiological picture of hydatid was present and it was reported as neoplastic. 14 Malignant lesions were the most common accounting for 79.22%. This is similar to the other studies 1,3,4,5,6,7,8 Benign spindle cell lesions are difficult to aspirate and the diagnostic accuracy for benign lesions ranges from 10-50% and for malignant lesions is high upto 95%.…”

Aspergillus Coinfection in a Hydatid Cyst Cavity of Lung in an Immunocompetent Host: A Case Report and Review of Literature

“…Antifungal agents or anthelminthic agents were not used in our case preoperatively. 4 cases received antifungal or anthelminthic therapy before surgery while one case was treated medically only [13,[34][35][36]39]. In our review of 11 published cases, standard lobectomy was performed in 5 cases, 5 cases underwent thoracotomy or cystectomy with/ without capitonnage, and 1 case was treated medically only.…”

An unusual combination of aspergillosis in multiple hydatid cysts in an immuno-competent patient

“…Aspergillosis (non-invasive aspergilloma), allergy bronchopulmonary aspergillosis, chronic pulmonary aspergillosis, and invasive pulmonary aspergillosis can all develop as a result of Aspergillus colonization in these situations. According to the location, a variety of microorganisms may superinfect hydatid and other cysts, with Aspergillus being rarely reported in hydatid cysts [ 3 ]. Aspergillosis and cystic echinococcosis share nearly the same symptoms and crescent signs on a chest CT scan.…”