PMC6197673_01
Chest roentgenogram, prior to biopsy.
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Routine X-ray demonstrated an RML lesion and a follow-up CAT showed a 4.5 cm x 3.7 cm lobulated mass of low attenuation, pleural-based at the right lateral lung field; referral to outpatient clinic for CAT-guided percutaneous aspiration needle biopsy of the RML lesion previously seen on Chest X-ray (CXR) (see Fig. 1). 20 mL of clear fluid was aspirated and sent for study.
Chest roentgenogram, following biopsy.
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CXR performed after the procedure revealed a mild right lung atelectasis and effusion and small apical pneumothorax, which were followed to resolution (see Fig. 2, Fig. 5).
CT of chest before biopsy, showing the presence of a cystic structure, as well as pleural effusion.
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She was instructed to follow-up in the Medicine, Pulmonary and Infectious Disease outpatient clinics (see Fig. 3, Fig. 4, Fig. 6).
Follow up CAT scan of chest at 3 months, showing resolution of pleural effusion and no new masses.
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Follow up CAT scan of chest (see Fig. 5) and Abdominal Ultrasound showed resolution of pleural effusion and no new masses.
Pathology Slide: Microscopic examination of the right lung wedge resection revealed lack of an epithelial lining of the cyst. The cyst wall was laminated and pink, highly suggestive of echinococcal cyst. No scolices or hooklets were seen. Fibrinous exudates, granulation tissue, and lymphoid aggregates were seen adjacent to the cyst. In the surrounding lung parenchyma, edema, hemorrhage and interstitial fibrosis were observed. Grossly, the cyst measured 2.5 x 2.5 x 2 cm, with a smooth, pearly white, glistening inner and outer surfaces and wall thickness less than 0.1 cm. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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She was instructed to follow-up in the Medicine, Pulmonary and Infectious Disease outpatient clinics (see Fig. 3, Fig. 4, Fig. 6).