title: Middle lobe syndrome: a singularly rare presentation of complicated pulmonary hydatid disease.
abstract: Imaging is crucial to the diagnosis of pulmonary hydatid disease, as it is often the first modality that raises suspicion of the disease. Middle lobe syndrome (MLS) as a presentation of this disease is a distinct rarity. A 45-year-old woman, a never-smoker, presented with cough and streaky haemoptysis. Imaging demonstrated a trapezoidal opacity with its base towards the hilum and contiguous with the right cardiac border. The reformatted sagittal view confirmed the diagnosis of MLS. Fibreoptic bronchoscopy (FOB) revealed an avascular white membranous structure wholly occluding the medial segment of the middle lobe. This was completely removed through gentle suction. Bronchial aspirate revealed hooklets of hydatid and echinococcal serology was positive. Subsequently, three cycles of albendazole were administered with remarkable clinical and radiological improvement. To the best of our knowledge, this is the first detailed description of MLS caused by pulmonary hydatidosis that was completely removed through FOB.
authors.affiliation: Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
authors.forename: Shekhar
authors.initials: S
authors.lastname: Kunal
authors.affiliation: Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Pilaniya
authors.affiliation: Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Shah
mesh_terms: D015766:Albendazole / Q000627:therapeutic use; D001999:Bronchoscopy / Q000379:methods; D004445:Echinococcosis, Pulmonary / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D008878:Middle Lobe Syndrome / Q000000981:diagnostic imaging* / Q000469:parasitology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D015766:Albendazole