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| RADIOLOGY QUIZ |
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| Year : 2023 | Volume
: 6
| Issue : 1 | Page : 31 |
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A radiological sign as a clue to diagnosis
K Kalaiyarasan
Department of Respiratory Medicine, Sri Venkateshwaraa Medical College, Hospital and Research Centre, Puducherry, India
| Date of Submission | 23-Feb-2023 |
| Date of Acceptance | 28-Mar-2023 |
| Date of Web Publication | 29-Apr-2023 |
Correspondence Address:
Dr. K Kalaiyarasan
Department of Respiratory Medicine, Sri Venkateshwaraa Medical College, Hospital and Research Centre, Puducherry
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/japt.japt_7_23
How to cite this article:
Kalaiyarasan K. A radiological sign as a clue to diagnosis. J Assoc Pulmonologist Tamilnadu 2023;6:31 |
A 47-year-old woman came to the emergency room complaining of right-sided chest pain, cough, and expectoration for 1 day. Identify the radiological sign.
| Discussion | |  |
The water-lily sign, also known as the camalote sign, is seen in hydatid cysts. It is due to the detachment of the endocyst membrane, which crumples and floats in the cyst fluid and mimics the appearance of a water lily. The endocyst membrane may become detached due to decreased intracystic pressure, degeneration, host response, trauma, or following treatment.[1]
The chest X-ray [Figure 1] shows a large cyst with crumpled tissue-like material in the right upper and midzone. The computed tomography image [Figure 2] shows a large cyst in the right upper lobe containing thin layers of crumpled tissue that correspond to the endocyst membrane of the hydatid cyst.
Echinococcosis, or hydatid disease, is a parasitic disease caused by the larval stages of the Echinococcus species. The most common site of involvement is the liver, followed by the lungs (10%–30% of cases). Apart from the lungs, hydatid cysts may be present in the pleura, mediastinum, and chest wall. In pulmonary hydatid disease, right lung involvement is seen in approximately 60% of cases, and in 20% of cases, it may be bilateral. In 60% of the cases, the lower lobes are predominantly involved, and multiple cysts may be seen in 30% of cases.[2]
Serum Echinococcus IgG antibody was positive, and the patient was managed with surgical excision and anthelminthics.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Pedrosa I, Saíz A, Arrazola J, Ferreirós J, Pedrosa CS. Hydatid disease: Radiologic and pathologic features and complications. Radiographics 2000;20:795-817.  |
| 2. | Morar R, Feldman C. Pulmonary echinococcosis. Eur Respir J 2003;21:1069-77. |
[Figure 1], [Figure 2]
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