Disseminated cysticercosis-(cerebral and pulmonary)

Case contributed by Dr Irvine Sihlahla

Presentation

Headache, seizures and shortness of breath 3 weeks. No history of trauma

Patient Data

Age: 30 years
Gender: Male

CXR shows multiple soft tissue nodules of varying shapes and sizes within no zonal predilection but more concentrated in the mid and basal lung zones. Some of the nodules coal esce together. Nasogastric tube in situ with tip below the hemidiaphragm.

Bilateral randomly distributed innumerable soft tissue nodules within the lung parenchyma some showing subtle mineralization. The nodules are well appreciated on MIP images. No focal areas of cavitation or consolidation. No intra-thoracic lymphadenopathy.

Innumerable nodules within the brain parenchyma and cervical soft tissues some demonstrating internal calcifications. The soft tissue calcifications are oblong-shaped. Some of the nodules have an eccentric nodule consistent with a scolex. No hydrocephalus.

Case Discussion

Multiple pulmonary solid nodules some of which are calcified. In addition nodules with the cervical neck soft tissues and muscles. Classic findings of neurocysticercosis with multiple nodules in different stages. Differential includes metastatic pulmonary calcification commonly seen in patients with chronic renal failure. The patient was commenced on anti-helminths.

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