Cystic and Cavitary Lung Diseases: Focal and Diffuse

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Presentation transcript:

Cystic and Cavitary Lung Diseases: Focal and Diffuse Jay H. Ryu, MD, Stephen J. Swensen, MD Mayo Clinic Proceedings Volume 78, Issue 6, Pages 744-752 (June 2003) DOI: 10.4065/78.6.744 Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 1 Posteroanterior chest radiograph shows a cystic lesion in the left mid lung due to coccidioidomycosis infection. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 2 Computed tomogram shows a large smooth thin-walled cyst in the right upper lobe-a bronchogenic cyst. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 3 Computed tomogram of colon cancer metastatic to the lung. Note irregular but relatively thin-walled cystic structure. This is an unusual manifestation of adenocarcinoma metastatic to the lung. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 4 Computed tomogram of the chest shows a large cavitated squamous cell carcinoma. Note air-fluid level in mass and nodular irregular cavitary wall thickening consistent with malignancy; small right pleural effusion. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 5 Chest radiograph of patient with cavitating staphylococcal pneumonia. Note left lower lobe consolidation with large cavity and air-fluid level. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 6 High-resolution computed tomogram of patient with postprimary tuberculosis. Note multiple regions of cavitation with consolidation in the posterior aspects of the superior segments of both lower lobes. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 7 Computed tomogram of immunocompromised patient with invasive aspergillosis. Note cavitated mass (2 × 3 cm) with air crescent sign. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 8 Posteroanterior chest radiograph of patient with Wegener granulomatosis. Note bilateral lung nodules and masses with cavitation. The walls of the cavitated masses are greater than 4 mm. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 9 Computed tomogram of patient with lymphangioleiomyomatosis. Note pencil-thin smooth walls of multiple cystic lesions. The cysts were distributed homogeneously throughout the upper and lower lobes, characteristic of lymphangioleiomyomatosis. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 10 Computed tomogram of patient with pulmonary Langerhans cell histiocytosis. Note thin-walled cysts throughout both lungs. The cysts are slightly more irregular than the characteristic spherical mass cysts of lymphangioleiomyomatosis (Figure 9). Also distinct is the upper lung distribution seen with pulmonary Langerhans cell histiocytosis. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 11 High-resolution computed tomogram of patient with idiopathic pulmonary fibrosis (usual interstitial pneumonia). Note thin-walled cystic process in the lung periphery. There is also traction bronchiectasis consistent with a long-standing fibrotic process. This patient had a basilar distribution of this cystic disease, which is characteristic of usual interstitial pneumonia. From Ryu et al.67 Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 12 High-resolution computed tomogram of patient with bronchiectasis and Mycobacterium avium-intracellulare infection. Note changes of bronchiectasis and adjacent nodular infiltrates characteristic of this disease. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions

Figure 13 Computed tomogram of lungs of patient with metastatic Leydig cell tumor of the testes. Note combination of nodules and very smooth thin-walled cystic lesions determined pathologically to be metastatic disease. Mayo Clinic Proceedings 2003 78, 744-752DOI: (10.4065/78.6.744) Copyright © 2003 Mayo Foundation for Medical Education and Research Terms and Conditions