Chest
Special FeaturesCystic Lung Diseases: Algorithmic Approach
Section snippets
Systematic Approach to Cystic Lung Disease
A summary of the systematic approach to cystic lung disease is given in Figure 6.
Additional Testing (Other than HRCT Scan)
While HRCT scan is extremely useful in diagnosing cystic lung disease, further testing and confirmation may be required to establish a definite diagnosis and to initiate specific treatment. Diseases where confirmation of diagnosis (in the presence of compatible cystic change on HRCT) is recommended prior to initiation of treatment include:
- 1)
LAM: Confirmatory features may include the presence of angiomyolipomas, chylous effusions, lymphangioleiomyoma, elevated serum vascular endothelial growth
Conclusions
In this review, we provide a systemic approach to aid clinicians in the diagnosis of cystic lung disease. Rather than classify each diagnosis in a single category, we have taken the most common presentations of each entity and placed them in one or more categories. Characteristics of cysts on HRCT imaging, considered together with clinical features, are helpful in guiding diagnostic and management strategies. First, we differentiate cysts from cavities, panlobular and centrilobular emphysema,
Acknowledgments
Financial/nonfinancial disclosures: The authors have reported to CHEST the following: D. L. is a consultant to Parexel, Inc, Boehringer Ingelheim, Inc, Genentech, Inc, Gilead, Inc, and Veracyte, Inc. He has received support from Parexel, Inc, Siemens, Inc, and the National Heart, Lung, and Blood Institute. D. N. is a consultant to Siemens Medical, Inc for their development of a computer-assisted detection device. None declared: (Suhail Raoof, P. B., R. V., J. R., N. G., Sabiha Raoof, J. G., M.
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