Case 94. Paragonimiasis (lung fluke) (34 y-o F)
         
    Surgical specimen of a cavity-forming lung lesion in a Thai housewife who stayed in Japan for several years    
         
   
Key words : Paragonimus westermani, cavity, Pragonimus miyazakii
   
         
   
zoonosis
   
     
 
     
The eroded bronchial wall shows marked inflammatory infiltration. Numbers of ova are seen within the wall (HE, low power). A pair of adult worms have been removed before histological sampling.   Numerous viable ova are seen in the bronchial wall (HE, high power). Eosinophilic reaction is milder in fluke infection than in nematode infection.
     
 
     
Reference case 94A
Sputum cytology from a 65 y-o male, showing a golden-yellow-colored asymmetric ovum of P. westermani. An operculum and yolk cells are seen in the egg. The patient ate Japanese freshwater crab (Geothelphusa dehaani) half year earlier.
  Reference case 94B
Frozen section of a subpleural coin lesion in a 54 y-o male (HE). Three calcified eggs are seen adjacent to epithelioid granuloma. No adult worm is seen, and eggs are few in number. Intrapulmonary pseudotubercle caused by P. miyazakii infestation is strongly suspected.
     
 
     
Paragonimus miyazakii seen in a dog bronchus
A pair of flukes observed within the bronchial lumen (HE, low power). The flukes are always paired, although both are bisexual in nature. The final hosts of P. miyazakii are the rat, weasel and wild pig.
  Paragonimus miyazakii seen in a dog bronchus
Body wall of the fluke and laid eggs outside the body (HE, high power). The body wall consists of the cuticle, subcuticular muscle cells and vitelline follicles in the spongy matrix. Eggs are laid out.