A nodular pulmonary lesion due to Linguatula serrata in an HIV-positive man.

A coin-shaped pulmonary lesion was accidentally detected in a 42-year-old, HIV-seropositive man residing in Bari (Apulia, Southern Italy) during a routine X-ray examination. A lung cancer was suspected, obliging physicians to investigate surgically. After thoracotomy a lung nodule, 1.8 cm in diameter, was excised and submitted for histological examination. Histological analysis revealed a nodular infarctual lesion containing a larva of Pentastomida. Despite the poor state of preservation of the parasite it was possible to recognise some morphological characteristics which enabled the parasite to be identified as Linguatula serrata (Pentastomida, Porocephalida). This is the first case reported in Europe in the lung in a living man due to this parasite, the few others occurring in autopsy reports. No evident correlations were found in the present case between HIV-seropositivity and the development of the parasitosis. The importance of lung nodules caused by metazoan invertebrates is emphasised: even though they are rare in man, they are regularly mistaken for cancer at X-ray examination.