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30 November 2021: Articles

Hydatid Pulmonary Embolism: A Case Report and Literature Review

Challenging differential diagnosis, Rare disease

Adila Aili A , Liqing Peng A , Jiarui Zhang B , Yu Liu B , Lige Peng B , Qun Yi A , Haixia Zhou A*

DOI: 10.12659/AJCR.934157

Am J Case Rep 2021; 22:e934157

Table 1. Reported cases of pulmonary embolism due to hepatic hydatid disease.

StudyPatient age (years)/sexClinical presentationImaging manifestationLocation of hydatid cystTreatmentOutcome
Yague et al (1998) []3 44/MaleHemoptysisCT: 2 oval masses of 40 and 20 mm located in the pulmonary arteries; MR: hypointense in T1-weighted images and hyperintense in T2-weighted imagesRight, left pulmonary arterySurgery: thoracotomyNot mentioned
Yuan et al (2014) []4 70/MaleDyspnea, intermittent coughEnhanced CT: low-density filling defect in the pulmonary artery, complete occlusion of the lumenleft lung lower lobe segmental pulmonary arterySurgeryNot mentioned
Lioulias et al (2001) []5 57/MaleLeft chest pain, dyspnea, cyanoticCTA: cystic lesions, complete and partial occlusion of the relevant pulmonary arteries; MR-angiography: multiple cysts in the pulmonary arteryLeft pulmonary artery, distal branches of the right pulmonary arterySurgery: thoracotomyAfter 42 months the patient is asympto-matic
Alper et al (1995) []7 55/MaleDyspneaCT: low-density lesions in the pulmonary artery, well-defined oval shape and with water density. MRI: a cystic lesion, hypointensity on Tl-weighted images and hyperintensity on T2-weighted images; a thrombosis lesion, moderately hyperintense on all sequences. Conventional pulmonary angiography: total occlusion of the relevant arteriesRight main pulmonary artery and left lower lobe arterySurgery: Dissected right pulmonary arteryNot mentioned
Karantanas et al (2000) []8 67/MaleDyspnea, cough, hemoptysisEnhanced CT: multiple echinococcal cysts in both lungs and a hypodense mass located in the left pulmonary artery compatible with intra-arterial hydatid cyst. MRI: multiple cysts sub-pleurally with mild wall enhancement and a similar cystic lesion in the lumen of the left pulmonary arteryLeft pulmonary arteryMebendazoleAfter 19 months there has not been deterioration
Kokasal et al (2006) []9 24/MaleCough, hemoptysisCT: a para-hilar cavitated mass-like lesion, a cavitary lesion in the upper lobe and disseminated parenchymal infiltration in the right lung; right pulmonary artery was occluded with a hypodense lesion. MRI: complete occlusion of the right pulmonary arteryRight pulmonary arterySurgery: Dissected right pulmonary arteryAfter 14 months no pathology has been detected
Akgun et al (2011) []10 43/MaleHemoptysis, abdomen pain, chest pain, dyspneaCT: multiple cystic emboli in the pulmonary arteries, vessel enlargement, multiple cystic parenchymal nodules in the lung lobes, and cystic embolus in the right atrium; the border between IVC and cystic component of the mass was undetermined Sonographic images: the border between the wall of the hydatid cyst and IVC was missingIVC, pulmonary artery, right atriumAlbendazoleAfter 2 months the patient is asympto-matic
Herek et al (2012) []11 31/FemaleChest pain, dyspnea, coughUltrasonography: a giant hydatid cyst lesion in the liver measuring 15×10 cm and compressing the portal and hepatic veins, germinal membrane of the cyst extending into the IVC and right atrium. Enhanced CT: a giant hydatid cyst extending into the right atrium via the IVC, embolization of the cyst contents into the pulmonary arteries, near-complete occlusion of the lumenRight atrium, IVC, left main and left lower lobe pulmonary arteriesSurgery and albendazoleNot mentioned
Abid et al (2011) []13 16/MaleHemoptysis, chest pain, dyspneaCT: distended distal branches of the right and left pulmonary artery, partial occlusion by cystic lesions and multiple segmental defects; an intra-right atrial mass; echocardiography: a large cystic mass measuring 19×22 mm, with a large implantation basis adhesive to the right side of the inter atrial septum with an extension to the right ventricleDistal branches of the right and left pulmonary artery, right atrium and ventricleSurgery: thora-cotomy, albenda-zoleAfter 18 months the patient is asympto-matic
Mahouachi et al (2007)[]14 51/MaleHemoptysis, chest painEnhanced CT: multiple echinococcal cysts in both lungs and partial occlusion of a distal branches of the left pulmonary artery by cystic lesions, residual cavity in the liverDistal branches of the right and left pulmonary arteryAlbendazoleAfter 12 months the patient is asympto-matic
Savaş et al (2017) []15 48/FemaleDry cough, chest pain, dyspneaEchocardiography: right chamber dilatation with moderate tricuspid regurgitation and elevated pulmonary artery systolic pressure (75 mmHg). Unenhanced CT: multiloculated cystic lesions in the pulmonary artery; a large filling defect by contrast-enhanced CT. MRI: multiloculated cystic lesions, hyperintense in T2-weighted imagesRight pulmonary arterySurgery: embolectomyDead
Asri H et al (2019) []16 73/MaleDyspneaEchocardiography: enlarged pulmonary arteries, enlarged chambers of the right heart and elevated pulmonary systolic pressure (80mmHg). CT: a cystic filling defect of the pulmonary arteryMain and right pulmonary arteryAlbendazoleNot mentioned
CT – computer tomography; MRI – magnetic resonance imaging; CTA – computed tomography angiography; IVC – inferior vena cava.

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923