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Case Reports
. 2021 Feb 15;60(4):601-604.
doi: 10.2169/internalmedicine.5304-20. Epub 2020 Sep 30.

Pulmonary Sparganosis: Tunnel Sign and Migrating Sign on Computed Tomography

Mitsuru Matsuki  1 , Akira Higashiyama  2
Affiliations
Case Reports

Pulmonary Sparganosis: Tunnel Sign and Migrating Sign on Computed Tomography

Mitsuru Matsuki et al. Intern Med. .

Abstract

A 77-year-old woman presented at our hospital to undergo a close examination of an abnormal shadow which was observed on a chest radiograph. Contrast-enhanced computed tomography (CT) images in the lung window revealed a tortuous tunnel structure (tunnel sign), which was suspected to be the migration path of a parasite. Furthermore, CT images in the mediastinal window showed a linear filling defect from the right inferior pulmonary vein to the venous ostium in the left atrium (migrating sign), which was suspected to be a migrating parasite in the pulmonary vein. Tunnel and migrating signs on chest CT images were helpful in diagnosing pulmonary sparganosis.

Keywords: computed tomography; migrating sign; pulmonary sparganosis; tunnel sign.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
A chest radiograph shows right hilar lymphadenopathy (asterisk) and thickened linear opacification (arrow) in the right mid-lung zone.
Figure 2.
Figure 2.
A-E: Axial 5-mm contrast-enhanced computed tomography in the lung window shows a tortuous tunnel structure (arrows). Continually, subpleural nodules with surrounding ground-glass opacity were observed (D, E: thick arrows). The tunnel structure is suspected to be the parasite migration path (tunnel sign). F-J: (Fig. 2F at the same level as Fig. 2A) Axial 5-mm contrast-enhanced computed tomography in the mediastinal window shows a linear defect in right inferior pulmonary vein and venous ostium in the left atrium. Enlarged right hilar lymph nodes (arrowheads) are also observed. The linear defect is suspected to be a migrating parasite in the vessel (migrating sign).
Figure 3.
Figure 3.
A, B: Using a workstation (ZIO station 2, ZIO soft, Tokyo, Japan), the width of the linear filling defect was measured (A), and the length in six slices was measured and summed (B). The filling defect measured 5.5 cm in length and 2.1 mm in width, which is considered to reflect the size of migrating parasite.
Figure 4.
Figure 4.
A chest radiograph one month later shows a reduction of the linear opacification (arrow) in the right mid-lung zone.
See this image and copyright information in PMC

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