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Moon, Jung, Kim, Park, Kim, and Shin: A Case of Pulmonary Paragonimiasis Presented as Solitary Pulmonary Nodule and Suspected as Lung Cancer on 18F-Fluorodeoxyglucose Positron Emission Tomography
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 64(2): 133-137.

Published online: 29 February 2008

DOI: https://doi.org/10.4046/trd.2008.64.2.133

A Case of Pulmonary Paragonimiasis Presented as Solitary Pulmonary Nodule and Suspected as Lung Cancer on 18F-Fluorodeoxyglucose Positron Emission Tomography

Jae Young Moon, M.D.1, Ki Hwan Jung, M.D.1, Je Hyeong Kim, M.D.1, Hyung Joo Park, M.D.2, Young-Sik Kim, M.D.3, Chol Shin, M.D.1

1Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

2Department of Thoracic and Cardiovascular Surgery, Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

3Department of Pathology, Ansan Hospital, Korea University College of Medicine, Ansan, Korea.

Address for correspondence: Je Hyeong Kim, M.D. Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, 516, Gojan 1-dong, Danwon-gu, Ansan 425-707, Korea. Phone: 82-31-412-5950, Fax: 82-31-413-5950, chepraxis@korea.ac.kr

Received 10 January 2008       Accepted 23 January 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Pulmonary paragonimiasis continues to be a diagnostically challenging parasitic disease, despite a drastically decreased prevalence in South Korea during the past decade. Pulmonary paragonimiasis is characterized by fever, chest pain, and chronic cough with hemoptysis. Numerous radiographic and computed tomographic findings including the presence of pneumothorax, pleural effusion, and parenchymal lesions such as nodular or infiltrative opacities have been reported. The clinical and radiological manifestations of paragonimiasis can resemble those of lung cancer, tuberculosis or a metastatic malignancy. Furthermore, this disease can mimic lung cancer as seen on 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). We report a case of pulmonary paragonimiasis in a 48-year old man that presented with a solitary pulmonary nodule and was suspected as a lung cancer based on FDG-PET imaging.

Keywords: Pulmonary paragonimiasis, Solitary pulmonary nodule, Positron emission tomography

Figures and Tables

Figure 1
Chest computed tomography (CT) showed ill-defined nodular consolidation at apicoposterior segment of left upper lobe (A, B). The size of this spiculate lesion enlarged with increase of solid component, 2 months later (C, D).
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Figure 2
There was about 2×2.5 cm sized hypermetabolized lung nodule with peripheral ground glass opacity (GGO) in hilar area of left upper lobe (pSUV 3.9 g/ml). Mild increased FDG uptake in left hilar node, suggestive of lymph node metastasis, was also noted.
trd-64-133-g002
Figure 3
Gross specimen of left upper lobe (A) showed a poorly demarcated multilocular yellowish gray cystic lesion at the cut surface, measuring 2×2.4 cm. Histology of the resected mass revealed chronic granulomatous inflammation with adult parasite and many eggs, consistent with paragonimiasis (B, C. hematoxylin and eosin, ×200, ×400).
trd-64-133-g003

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