PMC5641579_01
CT imaging demonstrating nonspecific patchy sub-pleural consolidation anteriorly in the right upper lobe and in the apical segment of the left lower lobe.
RCR2-6-e00276-g001.jpg
PMC5641579_01_RCR2-6-e00276-g001.jpg
rcr2276-fig-0001
A 44-year-old Zimbabwean-born male was referred with a 12-month history of cough, areas of patchy sub-pleural consolidation on thoracic Computed Tomography (CT) (Fig. 1), and a significantly elevated serum Immunoglobulin subclass 4 (IgG4) level (4.61 g/L; normal range 0.08-1.4 g/L).
Histopathology of right upper lobe wedge biopsy. (A) Adult worms within blood vessels (H&E, 100x) and (B) granulomatous inflammation with numerous eosinophils surrounding schistosome eggs (H&E, 200x).
RCR2-6-e00276-g002.jpg
PMC5641579_01_RCR2-6-e00276-g002.jpg
rcr2276-fig-0002
Unexpectedly, this demonstrated adult schistosome worms within the pulmonary vessels and eggs with a florid granulomatous inflammatory reaction within the interstitium (Fig. 2).