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Schistosomiasis associated with a mediastinal mass: case report and review of the literature.

A 13-year-old girl presented with fever, night sweat, weight loss, abdominal pain, haematuria and hepatosplenomegaly. Urinalysis revealed many Schistosoma haematobium ova, but rectal snip examination was negative for schistosomal ova. X-ray and CT scan of the chest revealed enlargement of the anterior, superior, mediastinal and left suprahilar lymph node with an adjacent left pulmonary parenchymal opacity and small peripheral lesions on the right side. A bone marrow aspiration and biopsy was normal. The patient was treated with Praziquantel for her urinary schistosomiasis. Because of her clinical and radiological chest findings, the possibilities of lymphoma and tuberculosis were considered. Therefore, she underwent a thoracotomy and biopsy of her thoracic lesions. The histopathology revealed pulmonary granulomas surrounding schistosoma ova with reactive mediastinal lymph adenitis.