Learning objectives
To present a pictorial review of cystic lung disease cases encountered in our institution,
which is a tertiary referral centre for interstitial lung disease in the West Midlands.
Present common diagnostic features to help differentiate between common and uncommon cystic lung diseases.
To briefly discuss epidemiology and aetiology of these conditions
Background
A pulmonary cyst is a round confined space surrounded by an easily distinct epithelial or fibrous wall typically under 1mm which usually contains air but may contain fluid 1.
It appears as a round parenchymal lucency with a well-defined border12.
Cavities are airspaces with thicker walls over 4mm.
Cystic lung diseases encompass a wide group of uncommon disorders that can be difficult to diagnose due to the large amount of diseases associated with this presentation2.
Chest radiographs (CXR) in early cystic lung disease are often...
Findings and procedure details
Lymphangioleiomyomatosis
Lymphangioleiomyomatosis (LAM) is a rare and progressive disease that is almost exclusive to women of child bearing age and generally leads to respiratory failure 1,4,5,6 Prevalence in the UK is approximately 1 per million,
although the incidence increases in patients with tuberous sclerosis complex to 1% 1,4,6.
LAM is caused due to proliferation of atypical smooth muscle cells (LAM cells) particularly in pulmonary lymphatics,
small pulmonary vessels and airways,
causing obstruction and leading to the formation of cysts 4,5.
Other respiratory complications caused include...
Conclusion
There are a number of diseases that present as cystic lung diseases.
In this review we have discussed commonly encountered ones such as LAM and PLCH along with diseases that sometimes present with cystic changes.HRCT is generally the imaging modality of choice as CXR is less sensitive and may often appear normal. A multidisciplinary approach that considers the patient's clinical history in combination with examination findings and HRCT appearance allows effective diagnosis and in some cases can prevent the requirement for biopsy.
Personal information
Dr.
Esther Eden.
Foundation yeartwo doctor.
University Hospitals Birmingham.
Heartlands Hospital.
Birmingham.
B9 5SS
Dr.Shahid Hussain
Consultant Radiologist.
University Hospitals Birmingham.
Heartlands Hospital.
Birmingham.
B9 5SS
Dr.
F Shaukat
International Training fellow.
University Hospitals Birmingham.
Heartlands Hospital.
Birmingham.
B9 5SS
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