Tor M, Ozvaran K, Ersoy Y, Senol T, Altuntas N, Kiliçoglu G, Celik L
Department of Pulmonary Medicine, Sureyyapasa Center for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.
Respir Med. 2001 Mar;95(3):237-9. doi: 10.1053/rmed.2000.1024.
The aim of this study was to present the pitfalls in the diagnosis of complicated pulmonary hydatid disease and to discuss the unusual radiological presentations of this endemic disorder in Turkey. We retrospectively evaluated 34 patients (12 females) aged between 8 and 64 years, who were operated on at our centre between 1991 and 1998 and diagnosed with complicated pulmonary hydatid cyst histopathologically. Computerized tomography (CT) scans of these patients were reviewed double-blind by two radiologists. The patients were then divided into two groups: group 1: initial radiological impression is pulmonary hydatid cyst and group 2: initial radiological impression is not pulmonary hydatid disease. These two groups were evaluated in terms of symptoms, radiographical presentation and laboratory tests. The presence of cystic appearance, water-lily sign, ring enhancement concomitant with intact cysts unanimously led the radiologists to the diagnosis of complicated pulmonary hydatid cyst, whereas solid appearance and presence of bronchial obliteration made the diagnosis unlikely. In such circumstances patient history, laboratory findings and bronchoscopic evaluation helped the diagnosis. In conclusion, in endemic regions like Turkey, atypical radiological presentation of complicated pulmonary hydatid disease should be considered in the differential diagnosis of solid pulmonary lesions.
本研究的目的是阐述复杂型肺包虫病诊断中的陷阱，并探讨这种在土耳其流行的疾病不寻常的放射学表现。我们回顾性评估了1991年至1998年间在我们中心接受手术且经组织病理学诊断为复杂型肺包虫囊肿的34例患者（12名女性），年龄在8至64岁之间。两名放射科医生对这些患者的计算机断层扫描（CT）图像进行了双盲复查。然后将患者分为两组：第1组：最初的放射学印象为肺包虫囊肿；第2组：最初的放射学印象不是肺包虫病。从症状、影像学表现和实验室检查方面对这两组进行评估。囊肿样外观、睡莲征、完整囊肿伴环状强化一致地使放射科医生诊断为复杂型肺包虫囊肿，而实性外观和支气管闭塞则使诊断不太可能。在这种情况下，患者病史、实验室检查结果和支气管镜检查有助于诊断。总之，在土耳其这样的流行地区，在实性肺部病变的鉴别诊断中应考虑复杂型肺包虫病的非典型放射学表现。
