ROENTGENOLOGICAL DIAGNOSIS OF PARAGONIMIASIS

1.In the literature dealing with paragonimiasis there has been untilrecently no clear description of the roentgenographic appearance orpulmonary lesions in this disease.Certain characteristics of pulmonaryparagonimiasis observed in 61 cases are described in this paper.2.On the basis of x-ray findings and pathologic changes of this dis-ease,it is suggested that pulmonary paragonimiasis should be dividedinto four stages,namely,infiltrative,nodular or cystic,fibrotic andcalcified.3.Fifty-four of the 61 cases had repeated hemoptysis.This may beexplained by the characteristic pathologic changes of the paragonimuscyst,the fact that many small blood vessels are present within the matrixof the capsule and that the cyst communicates with the bronchus orbronchiole.4.The density of the paragonimus cyst is light;consequently if thecyst is placed too far from the film,its shadow may not be well shown.Some suggestions dealing with the technic of roentgen examination ofthe chest are offered.5.Two characteristics of pulmonary paragonimiasis as shown on thex-ray film—vacuoles and the perifocal radiating lines of fibrosis—arepointed out.6.Interstitial fibrosis and fibrotic changes of the cyst in the lungparenchyma are present in 88 per cent of the 61 cases(Table 5).7.The pleural changes of this disease are found in most cases at thebase of the lung.Thirty-six of the 61 cases had pleural thickening(10on both sides and 26 on one side),6 had pleurisy with effusion and onehad empyema.8.Paragonimiasis may sometimes be mistaken for pulmonary tuber-culosis,lung tumor or bronchiectasis.The differential diagnosis of thesediseases is briefly dealt with.