This past week at Morning Report we discussed about cystic lung disease. Below is pertinent information regarding lung cysts and what to include in the differential:
- Lung cyst is defined as a round parenchymal lucency or area of low attenuation with a thin wall
- Cysts can be found on CT scans (particularly high-res) and requires a work-up as they are never normal
- Differential for diseases characterized by lung cysts is broad ranging from isolated chest disorders to rare multisystem diseases
- Characteristic findings on imaging, clinical history, and pathological findings (i.e. biopsy) may help determine the diagnosis
- Important to distinguish pulmonary cyst from cavity
- Cysts usually are thin walled, <2-3mm thick) and contain air but occassionally fluid or solid material
- Cavities are defined as gas-filled spaces that develop in an area of pulmonary consolidation, mass, or nodule
- Differential to consider in patient who presents with cysts:
- Centrilobular emphysema
- Lymphangioleiomyomatosis (LAM)
- Langerhans cell histiocytosis
- Lymphocytic interstitial pneumonia (LIP)
- Pulmonary metastasis
- Barotrauma/ARDS
- Birt Hogg Dube syndrome
- Desquamative interstitial pneumonia (DIP)
- End stage IPF with honeycombing
- Sarcoidosis
