What is the differential diagnosis for lung cysts?
Lymphangiomyomatosis, tuberous sclerosis, Langerhans cell histiocytosis, lymphocytic interstitial pneumonitis, Birt-Hogg-Dube. Some say NF1 but this is controversial.
Numerous intrapulmonary cysts, the largest measuring 3 cm in the left lower lobe. Left upper lobe ground glass opacity occupies most of the apical segment. Regional cysts demonstrate air-fluid levels. Several pulmonary nodules: 17 x 14mm right lower lobe anterior segment (image 23 se 6); this nodule is of fluid attenuation 7 x 7mm right upper lobe (image 14 se 6) 6 x 6mm right apex (image 9 se 6) 7 x 6mm right lower lobe anterior basal segment (image 25 se 6) No thoracic lymphadenopathy. Moderately severe cardiomegaly.
Dense pleural calcification, right medial basal region. Mild central pulmonary arterial dilation. 2 low attenuation hepatic lesions: 14mm segment 2 anterior subcapsular, 8mm segment 7 posterior subcapsular
Appearances suggest lymphoid interstitial pneumonia. The left upper lobe GGO has a relatively wide DDx including haemorrhage and less likely aspiration or infection. Malignancy is considered unlikely.