PMC2813613_01
CT scan of the chest showing a cavity in the upper segment of the right lower lobe with lamellar internal echoes.
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A plain chest x-ray showed a thick wall cavity in the upper and mid zone adjacent to the right hilum. A high-resolution CT scan revealed a large cavity in the apical segment of the right lower lobe with extensive lamellar internal echoes (Figure 1).
A) Gross examination of the wedge resection of upper segment of right lower lobe of the lung revealed hydatid cyst wall with necrotic material. White arrow: resected lung tissue. Thin black arrow: Fungal necrotic material. Thick black arrow: Hydatid cyst membrane. B) Thin arrow showing fungal hyphae on the outer aspect of chitinous wall of the hydatid cyst. Thick arrow showing hyphae invading the chitinous wall of the hydatid cyst. C) Echinococcus hooklets (thin black arrow) and aspergillus hyphae and spores (thick black arrow) within the cyst cavity. Calcification also seen in the cyst material (white arrow).
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Gross examination of the specimen revealed a surprisingly whitish membrane of the cyst wall with fungal necrotic material inside (Figure 2). Histopathological examination confirmed the presence of hydatid cyst along with echinoccocus hooklets with invasive Aspergillus within the cyst wall (Figure 2).