Spontaneous Expulsion of a Hydatid Cyst During Flexible Bronchoscopy

Abstract

An elderly female presenting with a soft tissue density mass on computerized tomography scan in left lower lobe was taken up for flexible bronchoscopy. During the procedure, she coughed out a 9 by 8 cm saclike structure that was confirmed to be a hydatid cyst. It is a rare event and in the present case obviated the need for surgery.

Cytological Diagnosis of Pulmonary Hydatid disease by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Cyst Fluid

“…Although it is reported that usually the membrane is visible in case of ruptured cyst, in the present case membrane was observed in an unruptured cyst 6 . In pulmonary hydatid disease, Chest X-ray shows a clearly defined cyst displaying homogenous opacity in case of an uncomplicated cyst or air meniscus sign, double arch sign or water lily sign in case of a complicated cyst 2,7 …”

“…Bronchoscopy can contribute to the diagnosis by the visibility of the hydatid membranes or finding hydatid elements in the bronchial washing in case of a ruptured cyst. Bronchoscopic instillation of larvicidal agents 12 or even removal of hydatid cysts bronchoscopically, obviating the need for surgery, has also been reported 7 . In this case we were able to demonstrate the 3 layers of the hydatid cyst on EBUS (Fig.…”

“…Bronchoscopic instillation of larvicidal agents 12 or even removal of hydatid cysts bronchoscopically, obviating the need for surgery, has also been reported. 7 In this case we were able to demonstrate the 3 layers of the hydatid cyst on EBUS (Fig. 1C) that can aid in making the diagnosis even in cases where it is not suitable to aspirate the cyst.…”

“…6 In pulmonary hydatid disease, Chest X-ray shows a clearly defined cyst displaying homogenous opacity in case of an uncomplicated cyst or air meniscus sign, double arch sign or water lily sign in case of a complicated cyst. 2,7 Serological testing is an important tool in the diagnosis of hydatid cyst as it is noninvasive and has low cost. ELISA for IgG antibodies against Echinococcal antigen has a sensitivity of 85% to 90% for liver cysts but 50% to 56% in cases of lung cysts.…”

Bronchoscopic Diagnosis and Removal of a Ruptured Hydatid Cyst

“…1 Iran is one of these endemic areas. 3 We report 1 such case in which a hydatid cyst was diagnosed and also completely removed using a flexible bronchoscope. Pulmonary hydatid cyst commonly involves the right lobe.…”