An Unusual Case of Severe Cystic Lung Disease: A Case Report and Review of the Literature.

Cystic lung diseases are a heterogeneous group of disorders with varying presentations and pathophysiology. They present as air-filled lung cysts that are prone to rupture and result in spontaneous pneumothoraxes. While pulmonary cysts are not uncommon, cysts presenting later in life with unclear etiology are rare and result in both a diagnostic and therapeutic challenge. In this report, we present a case of an 82-year-old female presenting with shortness of breath and hemoptysis. Computed tomography (CT) angiogram showed multiple pulmonary cysts with one of the cysts containing an air-fluid level suspicious of superimposed infection. Pulmonary cysts are characteristic of different diseases that include but are not limited to Langerhans cell histiocytosis (LCH), lymphangioleiomyomatosis (LAM), and Birt-Hogg-Dube (BHD) syndrome. The differential diagnosis of cystic lung disease over the years has become more complex. Clinical context and radiological findings are essential for diagnosis.