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HYDATID DISEASE OF THE LUNGS

A ROENTGENOLOGIC STUDY OF 50 CASES

JIRAYR P. BALIKIAN M.D.1 and FAYSAL F. MUDARRIS M.D.2

1 Associate Professor of Radiology.
2 Resident in Radiology of the American University Medical Center, Beirut, Lebanon.

Roentgen analysis of 50 cases of hydatid disease of the lungs is presented.

The hydatid cysts of the lungs were commonly solitary, well circumscribed, polycyclic, unruptured, at the lung bases, and at the posterior segments.

They exhibited different rates of growth in the same patient with a maximum growth of 7 cm. in 7 months. The presence of 2 or more large well circumscribed masses were found to be virtually pathognomonic of simple hydatid cysts. Characteristics of multiple small cysts are presented.

The roentgen manifestations of rupturing and ruptured hydatid cysts included the classical roentgen signs; i.e., the crescent sign, the double arch sign, and the water lily sign. The "membrane" sign on bronchography and tomography and the "daughter cyst" sign are described and illustrated.

Included also are cases showing: empty pericyst; pericyst effusion; hydatid lung abscess; pleural reaction; pleural effusion; and empyema. Accompanying types of pneumonitis included the peri-pericyst allergic and bacterial pneumonitis and aspiration bronchopneumonia. Other complications and sequelae included atelectasis, fibrosis, bronchiectasis, bronchopleural and hepato-bronchial fistulae.

Other aids in diagnosis of hydatid cyst of the lungs included: concurrent characteristic dense rim shadows and calcifications in the liver, spleen and kidneys; liver scan; clinical history; serology; and sputum microscopy. A rim of dense curvilinear shadow in the breast was dignostic of hydatid cyst of the breast.

The incidences of secondary and exogenous re-infections and concurrent extrapulmonary hydatidosis are reported.


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