Young male with a large round radio-opacity on chest X-ray
The present case has been reported in the European Heart Journal Case Reports.

A 40-year-old man presented with history of fever, malaise, and cough for past 3 months. The patient reported of an intermittent, low grade fever, worse during the evening hours, significant malaise, cough associated with minimal, clear, mucoid expectoration, and significant dyspnoea, which used to worsen when he laid down on left side.

A large, round, well-defined, homogenous opacity in the right mid and lower zone of his chest X-ray was observed. Examination revealed raised JVP with prominent ‘a’ waves and decreased breath sounds with dull note on percussion over right mid lung field.

Transthoracic 2D echocardiogram revealed large well-defined anechoic cystic mass externally compressing the right atrium. There were no signs suggestive of pulmonary artery hypertension, or right ventricular dysfunction or pericardial involvement.

Follow-up 3D echo revealed anechoic cystic mass with sand drift echoes ‘falling snowflakes sign’ and septae. CT thorax revealed a large (4.8 cm × 5.2 cm) water-attenuation cyst with lamellar wall in mid-lobe of the right lung causing distal lobar collapse.

Histopathology revealed the lesion to be a hydatid cyst. Patient was discharged from hospital and was prescribed oral Albendazole therapy for 3 months. On a 3 and 6 months follow-up, the patient was asymptomatic.

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