2Department of Chest Surgery, University Of Health Sciences Yedikule Chest Diseases And Thorasic Surgery Training And Research Hospital, Istanbul, Türkiye
3Department of Pathology, University Of Health Sciences Yedikule Chest Diseases And Thorasic Surgery Training And Research Hospital, Istanbul, Türkiye
Abstract
Hydatid cyst (HC) is a zoonotic parasitic disease caused by the organism Echinococcus granulosus. Türkiye is among the countries where this disease is endemic. Lungs are the most common site of involvement after the liver. Diagnosis may not be easy when cysts are complicated. A 40-year-old female patient had complaints of shortness of breath and chest pain for one- month, as well as a new onset of fever. She was referred to our center because her complaints persisted despite antibiotic treatment. Her medical, family histories, and lifestyle habits were unremarkable. The physical examination was normal. Routine laboratory analyses,including a hemogram and serum biochemistry, were within normal ranges. However, C-Reactive Protein (CRP) levels were elevated. A cavitary lesion with an irregular inner wall was observed on the chest radiograph. The patient was unable to expectorate sputum. With regard to the preliminary diagnosis of tuberculosis, abscess, and malignancy, a fiberoptic bronchoscopy was performed. An off-white, folded, paper-like lesion was observed in a subsegment of the anteriorsegment of the right upper lobe bronchus. A biopsy was taken and it was seen that the lesion continued with its distal part. The pathology results indicated a germinal membrane belonging to a HC. We present the patient's endobronchial appearance, which is distinctive for ruptured HC. We believe that existing videobronchoscopic images will guide bronchoscopists. This case highlights the importance of considering a HC in the differential diagnosis of cavitary lesions.