Pulmonary Paragonimiasis Mimicking Lung Malignancy

A 50-year-old m an was adm itted to our hospital w ith a com plaint of blood-tinged sputum . Chest com puted tom ography (CT) showed a 37 m m sized heterogeneously lobulated enhancing mass in the central aspect of the left upper lobe and this m ass was abutting the adjacent m ediastinum (Fig. 1). There was either a focal fibrotic pleural thickening or fissural thickening adjacent to the pulmonary mass. Conglomerated enlarged lymph nodes were observed in the left paraaortic and left anterior cardiophrenic angle areas. 18-Fluorodeoxyglucose positron em ission tom ography dem onstrated hyperm etabolic activity in the left upper lobe and the right thyroid gland (Fig. 2). The pathology of the fine needle aspiration from the thyroid gland revealed papillary carcinom a. Since prim ary or m etastatic lung cancer could not be ruled out, video-assisted thoracic surgery was perform ed. The m icroscopic findings dem onstrated num erous eosinophil infiltrations and m any eggs of paragonimiasis westermani, which were observed in the necrotized granuloma area (Fig. 3). He was underwent subtotal thyroidectom y. M oreover, he subsequently received iodine ablation therapy due to papillary carcinoma with regional lym ph node invasion. (J Lung Cancer 2009;8(2):118󰠏119)