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  • Title: Narrowing the Differential Diagnosis of Cystic Lesions in Smokers with Expiratory CT Acquisition Using the Cyst-Airway Communication Hypothesis.
    Author: Hochhegger B, Patel PP, Zanon M, Müller E, Ferreira Correa L, Verma N, Mohammed TL, Quinto Dos Reis Hochhegger D, Irion K, Marchiori E.
    Journal: Lung; 2022 Dec; 200(6):817-820. PubMed ID: 36271930.
    Abstract:
    The aim of this study was to assess percentage respiratory changes (δ) in the size of pulmonary cysts of different smoking-related etiologies. Retrospectively, we measured the cystic lesions due to histopathological-confirmed honeycombing from interstitial pulmonary fibrosis, pulmonary Langerhans cell histiocytosis (PLCH), and paraseptal emphysema, using paired inspiratory and expiratory CT scans. In a sample of 72 patients and 216 lesions, the mean diameter of PLCH and honeycombing decreased during expiration (PLCH, δ = 60.9%; p = 0.001; honeycombing, δ = 47.5%; p = 0.014). Conversely, paraseptal emphysema did not show any changes (δ = 5.2%; p = 0.34). In summary, our results demonstrated that cysts in smokers with PLCH and honeycombing fibrosis get smaller during expiratory CT scans, whereas the size of cystic-like lesions due to paraseptal emphysema and bullae tend to remain constant during respiratory cycles. These results support the hypothesis of cyst-airway communication in some cystic diseases, which could assist in the differential diagnosis in smoking-related lung diseases.
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