Cystic lung disease: probable lymphocytic interstitial pneumonitis

Case contributed by Prof Oliver Hennessy

Presentation

Shortness of breath over many months. No known significant past medical conditions. Not on any medications. The patient has declined to have bronchoscopy or an open lung biopsy.

Patient Data

Age: 50
Gender: Female

Both lungs show numerous cysts in all zones. These cysts are located in a perivascular location.

Changes of groung glass opacification are also present bilaterally

These changes have remained unaltered over a 16 month period.

The perivascular location of the cysts and the ground glass appearance of the lungs is suggestive of a diagnosis of lymphocytic interstitial pneumonitis.

Case Discussion

When viewing a HRCT study of multiple lung cysts, it is important to establish whether the findings are those of multiple pulmonary cysts or airway abnormalities, as seen in emphysema, bronchiectasis, or bullous lung disease.

Cystic lung disorders include pulmonary Langerhans cell histiocytosis (PLCH), lymphangioleiomyomatosis (LAM), and lymphocytic interstitial pneumonitis (LIP).

Rarer causes of multiple lung cysts include light chain deposition disease, amyloidosis, Birt-Hogg-Dube syndrome and neurofibromatosis.

Cavitating lung metastases can also result in multiple cysts (lacunar metastases).

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Case Information

rID: 33270
Case created: 6th Jan 2015
Last edited: 9th Sep 2015
System: Chest
Inclusion in quiz mode: Included

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