Yiyit Nurettin, Görür Rauf, Candaş Fatih Hikmet, Yıldızhan Akın, Turhan Vedat, Işıtmangil Turgut
GATA Haydarpaşa Eğitim Hastanesi, Göğüs Cerrahisi Servisi, İstanbul, Türkiye, Turkey.
Turkiye Parazitol Derg. 2011;35(2):120-4. doi: 10.5152/tpd.2011.30.
Pulmonary hydatid cysts usually present as a single lesion, whereas multiple cases are rare. It is not easy to distinguish hydatid cyst and nodular lesions radiologically. Chest radiograph of a 22 years-old male patient who was admitted due to right sided chest pain, revealed bilateral pulmonary nodules. His computerized tomography (CT) showed 34 nodular densities in the right lung and 21 nodular densities in the left lung. At that time, metastatic lung disease was suggested . Tru-cut lung biopsy was non-diagnostic. Anti-E. granulosus IgG (ELISA) was positive and hydatid cyst disease (HCD) was set as a prediagnosis. A right thoracotomy was performed and more cysts in number than those in tomography were observed intraoperatively. Postoperatively, 800 mg per day albendazole treatment was started. CT at the second month of medical therapy revealed that the lesions were stable in number but their sizes were smaller. CT of the fourth month showed that some of the lesions became cavitary. HCD should be kept in to mind in case of doubtful radiological findings. Although main treatment modality is surgery for HCD, when all cysts can not remove with the surgical treatment in patient with multiple cysts, medical treatment can be administered.
肺包虫囊肿通常表现为单个病灶,而多发者罕见。从影像学上区分包虫囊肿和结节性病变并不容易。一名因右侧胸痛入院的22岁男性患者的胸部X线片显示双侧肺结节。他的计算机断层扫描(CT)显示右肺有34个结节状密度影,左肺有21个结节状密度影。当时怀疑为肺转移瘤。经皮肺穿刺活检未能明确诊断。抗细粒棘球绦虫IgG(酶联免疫吸附测定)呈阳性,初步诊断为包虫囊肿病(HCD)。遂行右开胸手术,术中发现囊肿数量比CT显示的更多。术后开始每天服用800毫克阿苯达唑进行治疗。药物治疗第二个月时的CT显示病灶数量稳定,但大小变小。第四个月的CT显示部分病灶形成空洞。对于影像学表现可疑的病例应考虑到HCD。虽然HCD的主要治疗方式是手术,但对于多发囊肿患者若手术无法切除所有囊肿,可进行药物治疗。