Hiroshi Sekiguchi, MD, Jun Suzuki, Bobbi S. Pritt, MD, Jay H. Ryu, MD

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Presentation transcript:

Coughing Up a Diagnosis: A Cavitary Lung Lesion with Worsening Eosinophilia Hiroshi Sekiguchi, MD, Jun Suzuki, Bobbi S. Pritt, MD, Jay H. Ryu, MD The American Journal of Medicine Volume 126, Issue 4, Pages 297-300 (April 2013) DOI: 10.1016/j.amjmed.2012.12.004 Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 1 A chest x-ray exposed a cavitary lesion in the right lower lobe. The American Journal of Medicine 2013 126, 297-300DOI: (10.1016/j.amjmed.2012.12.004) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 2 Computed tomography (CT) of the chest demonstrated a cavitary lesion measuring 5.9 × 5.0 × 6.8 cm in the right lower lobe and an air-fluid level within the cavitary lesion. The American Journal of Medicine 2013 126, 297-300DOI: (10.1016/j.amjmed.2012.12.004) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 3 A chest CT scan with a lung window disclosed a floating membrane inside the cavity. This is known as the serpent sign. The American Journal of Medicine 2013 126, 297-300DOI: (10.1016/j.amjmed.2012.12.004) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 4 An echinococcal hooklet was seen on a wet preparation of the patient's sputum (unstained, 1000x). The American Journal of Medicine 2013 126, 297-300DOI: (10.1016/j.amjmed.2012.12.004) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 5 This surgical specimen came from the patient's right lower lobe. A, It contains a granulomatous abscess with fragments of a thick laminated acellular layer (left, 200x). B, A degenerated echinococcal protoscolex is present as well (right, 400x). This is consistent with a hydatid cyst caused by E. granulosus (hematoxylin and eosin stain). The American Journal of Medicine 2013 126, 297-300DOI: (10.1016/j.amjmed.2012.12.004) Copyright © 2013 Elsevier Inc. Terms and Conditions