Pathologic and Radiologic Correlation of Adult Cystic Lung Disease: A Comprehensive Review

Abstract

The presence of pulmonary parenchymal cysts on computed tomography (CT) imaging presents a significant diagnostic challenge. The diverse range of possible etiologies can usually be differentiated based on the clinical setting and radiologic features. In fact, the advent of high-resolution CT has facilitated making a diagnosis solely on analysis of CT image patterns, thus averting the need for a biopsy. While it is possible to make a fairly specific diagnosis during early stages of disease evolution by its characteristic radiological presentation, distinct features may progress to temporally converge into relatively nonspecific radiologic presentations sometimes necessitating histological examination to make a diagnosis. The aim of this review study is to provide both the pathologist and the radiologist with an overview of the diseases most commonly associated with cystic lung lesions primarily in adults by illustration and description of pathologic and radiologic features of each entity. Brief descriptions and characteristic radiologic features of the various disease entities are included and illustrative examples are provided for the common majority of them. In this article, we also classify pulmonary cystic disease with an emphasis on the pathophysiology behind cyst formation in an attempt to elucidate the characteristics of similar cystic appearances seen in various disease entities.

CT Characteristics and Pathologic Basis of Solitary Cystic Lung Cancer

“…To date, the number of solitary cystic lung cancers reported in the English-language literature is not large, and the most recent references are case reports and small case reviews (7,(14)(15)(16)(17)(18). In this series, the most common pathologic types of solitary cystic lung cancer were adenocarcinoma (81 [87.1%] of 93), but in situ adenocarcinoma is rare (14).…”

Aspergilloma Superimposed Infection on Lymphoid Interstitial Pneumonia

“…testing (PFT) shows restrictive physiology with reduced FVC and FEV1, elevated FEV1/FVC and reduced total lung capacity. Typical CT findings of thin-walled, predominantly midzoned perivascular cysts associated with ground-glass attenuation and centrilobular nodules in a nonsmoker is highly suggestive of LIP [1,4]. Other frequent imaging findings include bilateral bronchovascular and interlobular septal wall thickening with lower lobe predilection.…”

“…ere is currently no consensus on first-line therapy for LIP, as controlled clinical trials have not yet been reported. e latest therapeutic regime consists of corticosteroids alone versus immunoglobulin therapy modification or cytotoxic drugs [4,8]. Further complicating matters include LIP in the presence of commonly associated immunodeficiency syndromes such as rheumatoid disease, HIV infections and dysgammaglobulinemia in which immunosuppressive agents may further exacerbate opportunistic infections.…”

Comparison of Long Term Follow-up Chest CT Imaging in Adult and Pediatric Patients with Humidifier Disinfectant-related Lung Injury

“…Cystic lung disease such as Langerhans cell histiocytosis or lymphocytic interstitial pneumonia can present bizarre shaped lung cysts in adults. 16 17 However, those diseases are very rare in childhood. 18 In the present study, bizarre lung cysts were more frequently observed in children than adults after cessation of similar exposure to HD in the same room, even if adults demonstrated chronic, typical centrilobular nodules.…”