Differential Chest Computed Tomography Findings of Pulmonary Parasite Infestation Between the Paragonimiasis and Nonparagonimiatic Parasite Infestation.

OBJECTIVE

The aims of this study were to evaluate the chest computed tomography findings of parasite infestation regardless of pathogen and to compare the differential findings between paragonimiasis and nonparagonimiatic parasite infestation (NPPI).

METHODS

Between January 2008 and November 2011, 75 patients (46 men; 52.9 ± 14.1 years) with serologically proven parasite infestation and available chest computed tomography images were evaluated. Computed tomography images of 40 patients with paragonimiasis and 35 patients with NPPI (13 with sparganosis, 12 with toxocariasis, 8 with cysticercosis, and 2 with clonorchiasis) were assessed for the presence or absence of pleural abnormalities, consolidation, cavitary lesions, aggregated cysts, worm-migration tracts, and pure ground-glass opacity. Findings associated with consolidation were further assessed for characteristics including size, perilesional ground-glass opacity, presence of perilesional centrilobular nodules, and internal low attenuation, and multisegmentality and bilaterality were assessed for all patients.

RESULTS

In both groups, the most common pleural abnormality was pleural effusion (42.5% in paragonimiasis vs 22.9% in NPPI, P = 0.09), and the most common pulmonary abnormality was consolidation (82.5% vs 80.0%, P = 1.00). Multisegmentality (35% vs 42.9%, P = 0.64) and bilaterality (55.0% vs 60%, P = 0.82) of pleuropulmonary lesions were often observed in both groups. Internal low attenuation, perilesional centrilobular nodules, cavitary lesions, and worm-migration tracts were more frequently found in the paragonimiasis group (P ≤ 0.05).

CONCLUSIONS

The presence of internal low attenuation and perilesional centrilobular nodules associated with pulmonary consolidative lesions, along with cavitary lesions and worm-migration tracts, is more frequent in patients with paragonimiasis than in patients with NPPI.