Dados do Trabalho

Título

Cystic lung diseases and its mimics: A practical diagnostic approach for radiologists

Introdução e objetivo(s)

To provide an easy-to-follow algorithmic approach for diagnosing cystic lung diseases, based on Chest computed tomography (CT) findings and clinical information when appropriate.

Método(s)

Pulmonary cysts are a common finding in routine CT scans. Solitary/incidental cysts in asymptomatic individuals may represent part of the normal aging process. However, lung cysts can be a manifestation of an underlying disease and the diagnostic approach might be challenging.

Discussão

Initially, it is crucial to differentiate cysts from other air-filled lung lesions. Subsequently, cysts can be categorized into two main groups: solitary/localized cysts, which encompass incidental cysts and congenital cystic diseases, and multiple/diffuse cysts. Multiple/diffuse cysts can be further classified based on the presence or absence of associated radiologic findings, such as ground-glass opacity (GGO) or nodules, as well as preferential pulmonary segment involvement. Conditions lacking the aforementioned associated findings include diseases like lymphangioleiomyomatosis (with a diffuse distribution of cysts) and Birt-Hogg-Dubé syndrome (characterized by subpleural lentiform cysts). On the other hand, multiple/diffuse cysts may exhibit either ground-glass opacity or small nodules. Nodules may indicate conditions such as Langerhans cell histiocytosis (with sparing of the costophrenic angle in smokers), cystic metastasis (with peripheral cysts and a history of malignancy), or amyloidosis. Ground-glass opacity could be suggestive of conditions like pneumocystis pneumonia, desquamative interstitial pneumonia, or lymphocytic interstitial pneumonia (with cysts mainly located at the lung bases in patients with Sjögren's syndrome).

Conclusões

The proposed diagnostic approach based on CT scan findings and the patient's clinical information might be helpful to narrow down the differential diagnosis of cystic lung diseases and minimize the need for costlier and invasive diagnostic methods.

Palavras Chave

Cysts; Lung; Cystic lung diseases

Arquivos

Área

Tórax