Focal lung pneumatosis

Focal lung pneumatosis
CT scan of the lung showing bullae in the lower lung lobes of a subject with type alpha-1-antitrypsin deficiency. There is also increased lung density in areas with compression of lung tissue by the bullae.
SpecialtyRespiratory

A focal lung pneumatosis is an enclosed pocket of air or gas in the lung and includes blebs, bullae, pulmonary cysts, and lung cavities. Blebs and bullae can be classified by their wall thickness.[1]

  • A bleb has a wall thickness of less than 1 mm.[2] By radiology definition, it is up to 1 cm in total size.[3] By pathology definition, it originates in the pleurae (rather than in the lung parenchyma).[4]
  • A bulla has a wall thickness of less than 1 mm.[2] By radiology definition, it has a total size of greater than 1 cm.[3] By pathology definition, it originates in the lung parenchyma (rather than in the pleurae).[4]
  • A lung cyst has a wall thickness of up to 4 mm.[2] A minimum wall thickness of 1 mm has been suggested,[2] but thin-walled pockets may be included in the definition as well.[5]
  • A cavity has a wall thickness of more than 4 mm.[2]

The terms above, when referring to sites other than the lungs, often imply fluid content.

Lung cysts are seen in about 8% of the general population, with an increased prevalence in older people, and are not associated with emphysema.[5] They may be part of the aging changes of the lungs, and cause a slight decrease in their diffusing capacity.[5] The presence of multiple pulmonary cysts may indicate a need to evaluate the possibility of bullous or cystic lung diseases.[5] Cavitation indicates workup for serious infection or lung cancer.

  1. ^ Gaillard, Frank. "Pulmonary bullae | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Retrieved 16 June 2019.
  2. ^ a b c d e Dr Daniel J Bell and Dr Yuranga Weerakkody. "Pulmonary cyst". Radiopaedia. Retrieved 2019-05-01.
  3. ^ a b Hansell, DM.; Bankier, AA.; MacMahon, H.; McLoud, TC.; Müller, NL.; Remy, J. (March 2008). "Fleischner Society: glossary of terms for thoracic imaging". Radiology. 246 (3): 697–722. doi:10.1148/radiol.2462070712. PMID 18195376.
  4. ^ a b Katzenstein (2016). Diagnostic atlas of non-neoplastic lung disease : a practical guide for surgical pathologists. New York, NY: Demos Medical Publishing, LLC/Springer Publishing Company. ISBN 978-1-61705-229-3. OCLC 951217791.
  5. ^ a b c d Araki, Tetsuro; Nishino, Mizuki; Gao, Wei; Dupuis, Josée; Putman, Rachel K; Washko, George R; Hunninghake, Gary M; O'Connor, George T; Hatabu, Hiroto (2015). "Pulmonary cysts identified on chest CT: are they part of aging change or of clinical significance?". Thorax. 70 (12): 1156–1162. doi:10.1136/thoraxjnl-2015-207653. ISSN 0040-6376. PMC 4848007. PMID 26514407.