Parasites, Hosts and Diseases

The Korea Society for Parasitology and Tropical Medicine (대한기생충학·열대의학회)
권호 표지
DOI QR코드

DOI QR Code

A Pulmonary Paragonimiasis Case Mimicking Metastatic Pulmonary Tumor

  • Kim, Ki-Uk (Departments of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Kwang-Ha (Departments of Internal Medicine, Pusan National University School of Medicine) ;
  • Park, Hye-Kyung (Departments of Radiology, Pusan National University School of Medicine) ;
  • Jeong, Yeon-Joo (Departments of Parasitology, Pusan National University School of Medicine) ;
  • Yu, Hak-Sun (Departments of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Min-Ki
  • Received : 2010.11.30
  • Accepted : 2011.01.13
  • Published : 2011.03.15
Download PDF
⟨ Previous Next ⟩

Abstract

Pulmonary paragonimiasis is a relatively rare cause of lung disease revealing a wide variety of radiologic findings, such as air-space consolidation, nodules, and cysts. We describe here a case of pulmonary paragonimiasis in a 27-year-old woman who presented with a 2-month history of cough and sputum. Based on chest computed tomography (CT) scans and fluorodeoxyglucose positron emission tomography (FDG-PET) findings, the patient was suspected to have a metastatic lung tumor. However, she was diagnosed as having Paragonimus westermani infection by an immunoserological examination using ELISA. Follow-up chest X-ray and CT scans after chemotherapy with praziquantel showed an obvious improvement. There have been several reported cases of pulmonary paragonimiasis mimicking lung tumors on FDG-PET. However, all of them were suspected as primary lung tumors. To our knowledge, this patient represents the first case of paragonimiasis mimicking metastatic lung disease on FDG-PET CT imaging.

Keywords

References

  1. Yokogawa M. Paragonimus and paragonimiasis. Adv Parasitol 1965; 3: 99-158.
  2. Nakamura-Uchiyama F, Mukae H, Nawa Y. Paragonimiasis: a Japanese perspective. Clin Chest Med 2002; 23: 409-420. https://doi.org/10.1016/S0272-5231(01)00006-5
  3. Mukae H, Taniguchi H, Matsumoto N, Iiboshi H, Ashitani J, Matsukura S, Nawa Y. Clinicoradiologic features of pleuropulmonary Paragonimus westermani on Kyusyu Island, Japan. Chest 2001; 120:514-520. https://doi.org/10.1378/chest.120.2.514
  4. Chang JM, Lee HJ, Goo JM, Lee HY, Lee JJ, Chung JK, Im JG. False positive and false negative FDG-PET scans in various thoracic diseases. Korean J Radiol 2006; 7: 57-69. https://doi.org/10.3348/kjr.2006.7.1.57
  5. Watanabe S, Nakamura Y, Kariatsumari K, Nagata T, Sakata R, Zinnouchi S, Date K. Pulmonary paragonimiasis mimicking lung cancer on FDG-PET imaging. Anticancer Res 2003; 23: 3437-3440.
  6. Yoo IeR, Park HJ, Hyun J, Chung YA, Sohn HS, Chung SK, Kin SH. Two cases of pulmonary paragonimiasis on FDG-PET CT imaging. Ann Nucl Med 2006; 20: 311-315. https://doi.org/10.1007/BF02984648
  7. Osaki T, Takama T, Nakagawa M, Oyama T. Pulmonary Paragonimus westermani with false-positive fluorodeoxyglucose positron emission tomography mimicking primary lung cancer. Gen Thorac Cardiovasc Surg 2007; 55: 470-472. https://doi.org/10.1007/s11748-007-0167-x
  8. Moon JY, Jung KH, Kim JH, Park HJ, Kim YS, Shin C. A case of pulmonary paragonimiasis presented as solitary pulmonary nodule and suspected as lung cancer on 18F-fluorodeoxyglucose positron emission tomography. Tuberc Respir Dis 2008; 64: 133-137. https://doi.org/10.4046/trd.2008.64.2.133
  9. Moon YR, Lee YD, Park SH, Cho YS, Na DJ, Cho YS, Han MS, Choi HJ, Kim DH, Yang SO, Kim KH. A case of paragonimiasis that was suspicious for a lung malignancy by PET/CT. Tuberc Respir Dis 2007; 63: 521-525. https://doi.org/10.4046/trd.2007.63.6.521
  10. Im JG, Whang HY, Kim WS, Han MC, Shim YS, Cho SY. Pleuropulmonary paragonimiasis: radiologic findings in 71 patients. AJR 1992; 159: 39-43. https://doi.org/10.2214/ajr.159.1.1609718
  11. Kim TS, Han J, Shim SS, Jeon K, Koh WJ, Lee I, Lee KS, Kwon OJ. Pleuropulmonary paragonimiasis: CT findings in 31 patients. AJR 2005; 185: 616-621. https://doi.org/10.2214/ajr.185.3.01850616
  12. Franquet T, Muller NL, Gimenez A, Guembe P, de La Torre J, Bague S. Spectrum of pulmonary aspergillosis: histologic, clinical, and radiologic findings. Radiographics 2001; 21: 825-837. https://doi.org/10.1148/radiographics.21.4.g01jl03825
  13. Hubner KF, Buonocore E, Gould HR, Thie J, Smith GT, Stephens S, Dickey J. Differentiating benign from malignant lung lesions using "quantitative" parameters of FDG PET images. Clin Nucl Med 1996; 21: 941-949. https://doi.org/10.1097/00003072-199612000-00005
  14. Yang SN, Liang JA, Lin FJ, Kwan AS, Kao CH, Shen YY. Differentiating benign and malignant pulmonary lesions with FDG-PET. Anticancer Res 2001; 21: 4153-4157.
  15. Cho SY, Hong ST, Rho YH, Choi S, Han YC. Application of micro-ELISA in serodiagnosis of human paragonimiasis. Korean J Parasitol 1981; 19: 151-156. https://doi.org/10.3347/kjp.1981.19.2.151
  16. Bast RC Jr, Klug TL, St John E, Jenison E, Niloff JM, Lazarus H, Berkowitz RS, Leavitt T, Griffiths CT, Parker L, Zurawski VR Jr, Knapp RC. A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer. N Engl J Med 1983; 309: 883-887. https://doi.org/10.1056/NEJM198310133091503

Cited by

  1. A Case of Pulmonary Paragonimiasis Mimicking Lung Cancer Diagnosed by EBUS-TBNA vol.84, pp.3, 2011, https://doi.org/10.3904/kjm.2013.84.3.423
  2. Clinical Update on Parasitic Diseases vol.85, pp.5, 2013, https://doi.org/10.3904/kjm.2013.85.5.469
  3. A Case of Delayed Diagnosis of Pulmonary Paragonimiasis due to Improvement after Anti-tuberculosis Therapy vol.77, pp.4, 2011, https://doi.org/10.4046/trd.2014.77.4.178
  4. A Case of Intra-abdominal Paragonimiasis Mimicking Metastasis of Lung Cancer Diagnosed by Endoscopic Ultrasound-guided Fine Needle Aspiration vol.66, pp.1, 2011, https://doi.org/10.4166/kjg.2015.66.1.41
  5. Recent Incidence of Paragonimus westermani Metacercariae in Freshwater Crayfish, Cambaroides similis, from Two Enzootic Sites in Jeollanam-do, Korea vol.55, pp.3, 2011, https://doi.org/10.3347/kjp.2017.55.3.347
  6. 객혈과 공동 폐병변으로 폐결핵으로 오인된 폐흡충증 1예 vol.24, pp.3, 2011, https://doi.org/10.14776/piv.2017.24.3.178
  7. Pulmonary larval paragonimiasis mimicking lung cancer vol.80, pp.2, 2011, https://doi.org/10.17116/patol201880260-63
  8. 폐흡충증으로 인한 대량 기흉 vol.17, pp.1, 2011, https://doi.org/10.22730/jmls.2020.17.1.25
  9. One delayed diagnosis of paragonimiasis case and literature review vol.9, pp.5, 2011, https://doi.org/10.1002/rcr2.750