FDG PET in Ruptured Pulmonary Hydatid Cyst Assessing Disease Extent and Tracking the Path of Drainage

A 13-year-old female hailing from a remote village presented with a history of intermittent fever, cough, and expectoration along with multiple episodes of hemoptysis. She was treated for tuberculosis without benefit before was she presented to us. Ultrasonography of the chest was suggestive of a loculated pleural effusion. Computed tomography (CT) scan of the chest revealed a loculated cyst in the left lung lingula and the tapping of the cyst demonstrated transudative fluid. The serum IgG titer for Echinococcus granulosus was raised (1:320). F-18 fluorodeoxyglucose-positron emission tomography (FDG PET) imaging was considered to ascertain the extent of disease involvement and tracking the path of drainage, based upon its potential useful role in assessing infection and inflammation that has been emphasized in the recent literature. The scan showed uptake in the wall of the cyst as well as a linear uptake along a track that was directed anteroinferiorly corresponding to the drainage track of the ruptured pulmonary hydatid cyst. This was in addition to the low grade tracer uptake in both sided hilar and mediastinal regions.