Diagnosis of pulmonary hydatid disease presenting with solid nodule and mimicking malignancy by fine needle aspiration cytology

Abstract

To the Editor, Hydatid disease (HD) is caused by Echinococcus granulosus, endemic in the cattle- and sheep-raising regions of the underdeveloped and developed world.[1,2] The prevalence is rather high in several countries of the Mediterranean region, mainly in pastoral areas where the dog-sheep cycle of the parasite prevails.[3] It also remains a health problem in Turkey, mainly in the rural areas of the eastern part of the country.[4] Hydatid disease predominantly affects the liver and lungs. The relatively rare anatomic locations are the central nervous system, muscles, subcutaneous tissue, kidneys, bones, and body cavities.[1] Pulmonary HD can be diagnosed by clinical and radiological findings, and serological analysis. However, old, arrested forms of the infection presenting with an organized, solid, atypical pulmonary nodule may mimic lung cancer.[5] Fine needle aspiration cytology (FNAC) can be a useful tool in the differential diagnosis.[6] We report a case of pulmonary hydatid cyst presenting with a solid and solitary nodule, clinically and radiologically suspicious for malignancy, diagnosed by FNAC. A 52-year-old female patient presented with a history of dyspnea and cough. Computed tomography (CT) revealed a solid nodular lesion, with a 2 cm diameter, in the apicoposterior segment of the upper lobe of the left lung [Figure 1]. Figure 1 Computed tomography image showing a nodular lesion (red arrow), 2 cm in diameter, in the apicoposterior segment of the upper lobe of the left lung A clinical and radiological diagnosis of lung malignancy was rendered, and subsequently a CT-guided transthoracic FNAC was done.