Enteric cyst in the left posterior mediastinum mimicking a hydatid cyst on chest computed tomography scan

Abstract Mediastinal enteric cysts are a rare occurrence among adults and are usually asymptomatic. In most cases they are an incidental finding in the right hemi-mediastinum and are associated with vertebral anomalies. We report the unusual case of a 23 year old male who had a mediastinal mass on chest X-ray as an incidental finding. Chest Computed Tomography (CT) scan revealed no vertebral anomalies and a cystic mass in the left posterior mediastinum with features similar to those of a hydatid cyst.Posterolateral thoracotomy was done and the cyst was excised. Histopathology report revealed it to be an enteric cyst

Lesões parasitárias atípicas em bovinos de abatedouro no sul do Brasil

In this study, we described the morphological features and unusual presentations of hydatidosis, fasciolosis, and eosinophilic myositis caused by Sarcocystis species diagnosed at the slaughterhouse lines. Twenty-seven samples of atypical parasitic lesions from distinct cattle were evaluated, of which 12 corresponded to hydatidosis, 11 to fasciolosis, and 4 to eosinophilic sarcocystosis. Hydatid cysts were observed mainly in the heart, with all cases involving the left ventricle. Fasciolosis lesions involved mainly the lungs, and were characterized by a focal nodular elevated area involving the edges of the lobes. Intralesional trematodes were observed in three cases. Sarcocystosis lesions were observed in four cases, and lesions were primarily located in the skeletal and cardiac muscles. Grossly, they presented as focal or focally extensive streaks, patches, or numerous nodules that were greenish to mildly yellowish. Histologically, all the cases had intralesional ruptured cysts of Sarcocystis that were associated with severe eosinophilic myositis and myocarditis. Parasitic lesions in atypical locations and/or with aberrant responses should be promptly identified because it may mistakenly diagnosed as other potentially zoonotic diseases, such as cysticercosis and tuberculosis.No presente estudo, são descritas as características morfológicas e as apresentações incomuns das lesões parasitárias de hidatidose, fasciolose e miosite eosinofílica por Sarcocystis spp., diagnosticadas nas linhas de abate. Foram analisadas 27 amostras de diferentes bovinos, das quais 12 correspondiam a casos de hidatidose, 11 de fasciolose e 4 de sarcocistose eosinofílica. Os cistos hidáticos foram observados predominantemente no coração, todos com localização no ventrículo esquerdo. As lesões de fasciolose envolveram principalmente os pulmões e eram caracterizadas por áreas nodulares e elevadas nos bordos dos lobos pulmonares. Trematódeos intralesionais estavam presentes em três casos. Lesões de sarcocistose foram observadas em quatro casos, com localização nos músculos esquelético e cardíaco. Macroscopicamente, observaram-se listras, manchas ou numerosos nódulos de coloração esverdeada a discretamente amarelada. Histologicamente, todos os casos apresentaram cistos intralesionais de Sarcocystis spp. rompidos e degenerados, associados à acentuada miosite e miocardite eosinofílica. A identificação das lesões parasitárias em locais poucos frequentes é de extrema importância, pois podem constituir diagnósticos diferencias de enfermidades zoonóticas, como cisticercose e tuberculose

Bilateral Pulmonary Artery, Inferior Vena Cava, and Cardiac Echinococcosis: A Rare Presentation of Zoonotic Diseases

Introduction:Cystic hydatidosis is a zoonoticdisease thatis mostly observedin the Mediterranean region. This infectious disease may present throughdifferent manifestations that may delay the diagnosis and cause various complications for the patients. Most of the cases are usually diagnosed by imaging studies and the related management could be medical or surgical depending on the patient’s clinical condition and disease severity. Case presentation:In the present report, we present the case ofa 50-year-old female patient with a positive history of liver and splenichydatid cysts with hemoptysis and dyspnea. The diagnosis of pulmonary and cardiac involvement wasmade usingcomputed tomography angiography. Despite the immediate surgery, the patient died from hemorrhage after 3 days. Conclusion:Themanagement of pulmonary embolism due to Echinococcus highly depends on the clinical judgment and the outcomes are subject to the history and extent of the involvement

Diagnostic accuracy of multidetector computed tomography scan in mediastinal masses assuming histopathological findings as gold standard

Purpose: Aim of the study was to: 1) present MDCT characteristics of different mediastinal mass lesions, 2) estimate proportion of benign and malignant mediastinal mass lesions based on MDCT findings, and 3) find out the diagnostic accuracy with sensitivity, specificity, positive predictive value, and negative predictive value of MDCT in mediastinal mass lesions assuming histopathology as gold standard. Material and methods: This study was an analysis of 60 patients who underwent MDCT scan for characterisation of mediastinal mass lesion, and subsequently imaging findings were verified with pathological diagnosis. Results: Out of 60 patients 65% were malignant and 35% were benign. Metastatic carcinoma was the leading diagnosis. Sensitivity of MDCT in this study came out to be 94%, specificity is 90%, with a positive predictive value of 94% and negative predictive value of 90% with diagnostic accuracy of 93%. Conclusions: Mediastinal mass lesion can be accurately diagnosed with MDCT which is a non-invasive and easily available modality requiring clinical data for accurate diagnosis and management. Co-relation of MDCT findings with other imaging findings is complex and requires adequate clinical data for optimum diagnostic confidence

Spontaneous rupture of giant hydatid cyst of lung into left bronchus: Preoperative diagnosis and treatment

Introduction: Hydatid disease is a parasitic infestation caused by Echinococcus granulosus in which human is accidental intermediate host. Lung is the most common site involved in children unlike adults, where liver is involved. Case report: 13-year-old girl who was asymptomatic, was found to have reduced air entry on left side during health checkup. Chest radiography (CXR) was suggestive of radio-opaque lesion obscuring left cardiac border and left dome of diaphragm. CT chest report was suggestive of intrapulmonary hydatid cyst. However, few hours after admission, she developed anaphylactic reaction which was managed successfully with adrenaline and steroids. Repeat chest readiograph was suggestive of decreased opacity, air fluid level noticed on dependent part of left lung. Rupture of the cyst was suspected. She underwent left thoracotomy and evacuation of hydatid cyst was done. Intra-operative findings were suggestive of broken endocyst, thoracic cavity filled with fluid with multiple bronchial openings. Conclusion: Hydatid cyst despite of its thick covering layers, undergoes spontaneous rupture occasionally. Anaphylactic shock due to rupture of cyst is a life threatening complication

Surgical treatment of cardiac echinococcosis: a case report

Echinococcosis refers is a chronic disease caused by tapeworms of the order Cyclophyllidea. Echinococcal cysts increase in size slowly and are often asymptomatic, and the symptoms of cardiac echinococcosis are nonspecific, which in turn can make diagnosis difficult. Early diagnosis and surgical treatment of this disease is crucial to prevent severe complications. Considering that the heart is affected extremely rarely, we want to demonstrate the successful surgical treatment

Case Series of Cystic Echinococcosis Over a Twelve-year Period at Sultan Qaboos University Hospital, Oman

Objectives: Cystic echinococcosis is a worldwide zoonosis that is endemic in many countries including some in the Middle East. Exact prevalence rates for human echinococcosis are unknown for Oman. Methods: Following obtaining ethical approval, data from January 2010 to December 2021 were retrieved from hospital electronic records of Sultan Qaboos University Hospital, Muscat. Results: Over a 12-year period we saw nine cases of hydatid disease; two cases in females and seven cases in males. The median age of our patients was 31 years old. Four patients had pulmonary cysts, four had hepatic cysts, and one patient had pulmonary and hepatic cysts. The majority of patients were from the Ad Dakhiliyah governorate. Contact with animals was reported by three patients, denied by two, and unknown for four. Albendazole was prescribed to three patients with pulmonary cysts that subsequently ruptured reflecting the unfamiliarity of clinicians to best manage pulmonary hydatid cysts. Conclusions: The prevalence of cystic echinococcosis in Oman is unknown but appears rare. For optimal management of this disease, clinicians must become more aware of its diagnosis and management

Volume 17, issue 4

The mission of CJS is to contribute to the effective continuing medical education of Canadian surgical specialists, using innovative techniques when feasible, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research. Visit the journal website at http://canjsurg.ca/ for more.https://ir.lib.uwo.ca/cjs/1127/thumbnail.jp

Epidemiology and strain differentiation of Echinoccus granulosus in Kenya

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