Department of Radiology, Korea University Guro Hospital, College of Medicine, Korea University, Seoul, Korea.
Department of Radiology, Korea University Ansan Hospital, College of Medicine, Korea University, Ansan, Korea.
Korean J Radiol. 2019 Sep;20(9):1368-1380. doi: 10.3348/kjr.2019.0057.
Lung cysts are commonly seen on computed tomography (CT), and cystic lung diseases show a wide disease spectrum. Thus, correct diagnosis of cystic lung diseases is a challenge for radiologists. As the first diagnostic step, cysts should be distinguished from cavities, bullae, pneumatocele, emphysema, honeycombing, and cystic bronchiectasis. Second, cysts can be categorized as single/localized versus multiple/diffuse. Solitary/localized cysts include incidental cysts and congenital cystic diseases. Multiple/diffuse cysts can be further categorized according to the presence or absence of associated radiologic findings. Multiple/diffuse cysts without associated findings include lymphangioleiomyomatosis and Birt-Hogg-Dubé syndrome. Multiple/diffuse cysts may be associated with ground-glass opacity or small nodules. Multiple/diffuse cysts with nodules include Langerhans cell histiocytosis, cystic metastasis, and amyloidosis. Multiple/diffuse cysts with ground-glass opacity include pneumocystis pneumonia, desquamative interstitial pneumonia, and lymphocytic interstitial pneumonia. This stepwise radiologic diagnostic approach can be helpful in reaching a correct diagnosis for various cystic lung diseases.
肺囊肿在计算机断层扫描（CT）上很常见，囊性肺部疾病表现出广泛的疾病谱。因此，正确诊断囊性肺部疾病对放射科医生来说是一个挑战。作为第一步，应将囊肿与空洞、大疱、肺气囊、气肿、蜂窝肺和囊性支气管扩张相区分。其次，囊肿可以分为单发/局限性与多发/弥漫性。单发/局限性囊肿包括偶然发现的囊肿和先天性囊性疾病。多发/弥漫性囊肿可根据是否存在相关影像学表现进一步分类。无相关发现的多发/弥漫性囊肿包括淋巴管平滑肌瘤病和 Birt-Hogg-Dubé 综合征。多发/弥漫性囊肿可伴磨玻璃影或小结节。伴有结节的多发/弥漫性囊肿包括朗格汉斯细胞组织细胞增生症、囊性转移和淀粉样变性。伴有磨玻璃影的多发/弥漫性囊肿包括肺孢子菌肺炎、脱屑性间质性肺炎和淋巴细胞性间质性肺炎。这种逐步的放射学诊断方法有助于对各种囊性肺部疾病做出正确诊断。
