Description
Due to the growing number of diseases linked to this presentation, multiple cystic lung disease represents a heterogeneous collection of rare conditions that can make diagnosis difficult. Chest high-resolution computed tomography is useful in defining the distribution and anatomical characteristics of lung cysts as well as any concomitant abnormalities. The majority of these disorders can be confidently and accurately diagnosed without the need for an open lung biopsy when imaging appearance, clinical characteristics, and extrapulmonary symptoms are combined, when present.
Résumé
- The presenter discusses a 70-year-old diabetic male with recurrent cough, fever, and sputum production for three years. The patient was treated with antibiotics and hospitalizations. Recent symptoms include fever, aggravated cough with greenish sputum, and shortness of breath. Clinical examination revealed wheezing and coarse crepitation in the left infrascapular and infra-axillary area. An X-ray showed right hilar prominence and haziness in the left lower zone.
- A CT scan revealed airway wall thickening, dilated bronchi, and a bronchogenic cyst. The cyst was deemed not to be a tracheal fistula or esophageal duplication. Differential diagnoses included tracheal fistula, which was ruled out due to a lack of history of airway procedures and clinical symptoms such as coughing after oral intake. The patient was treated with oral antibiotics, bronchodilators, physiotherapy, and vaccinations.
- The second case involves a 79-year-old male with shortness of breath and a long-standing smoking history. A CT scan, reported as bronchiectasis, showed small subplural bulet and varying sized airspace opacities. Other findings included airway bronchial wall thickening and nodular opacities, suggesting panacinar or centriacinar emphysema and pulmonary Langheran Cell histiocytosis. The patient was treated with bronchodilators and pulmonary rehab measures.
- The third case focuses on a 75-year-old male with a history of CAD, stenting, and severe LV dysfunction. The patient’s primary complaint was shortness of breath, prompting a pulmonology evaluation. Clinical signs indicated COPD, but initial treatment was delayed. A CT scan revealed significant emphysematous changes with bullae. The patient was treated with bronchodilator therapy.
- The presentation emphasizes the importance of differentiating between various lucent lung diseases. While some lucencies are cystic lung diseases, other conditions like emphysema, bullae, bronchiectasis, and cavitary lesions can mimic them. Accurate diagnosis requires careful CT chest evaluation, a proper clinical history, and awareness of distinct radiological patterns.
- Cystic lung diseases are defined as round paranal lucencies with a well-defined interface with normal lung tissue. Common cystic lung diseases include lymphangiomyomatosis, pulmonary Langheran Cell histiocytosis, Birt-Hogg-Dube syndrome, lymphoid interstitial pneumonia, and bronchogenic cysts. Each condition has specific clinical and radiological characteristics to aid in differential diagnosis.
Exemple de certificat
À propos des intervenants
Dr Gangi Reddy
Pneumologue consultant
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