Skip to main content
SpringerLink
Log in

Pathological Evaluation of Pulmonary Cysts

  • Chapter
  • First Online:
Diffuse Cystic Lung Diseases

Part of the book series: Respiratory Medicine ((RM))

  • 591 Accesses

Abstract

The pathological approach to diffuse cystic lung disease (DCLD) requires recognition of a cyst, careful histological examination of the cyst wall and adjacent lung parenchyma, exclusion of cyst mimics, and correlation with clinical and radiographic information. Using this standard approach allows definitive recognition of the etiology of the cystic lesions in most cases. This chapter reviews pathological features of common and uncommon causes of DCLDs. Salient clinical and radiographical features that assist the pathologist are discussed. Finally, pathological features of the cyst mimics are explored.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

A1ATD:

Alpha 1 antitrypsin deficiency

BHD:

Birt-Hogg-Dube syndrome

CLE:

Centrilobular emphysema

CPAM:

Congenital pulmonary airway malformation

CTD:

Connective tissue disease

DCLD:

Diffuse cystic lung disease

DIP:

Desquamative interstitial pneumonia

ECD:

Erdheim-Chester disease

ESS:

Endometrial stromal sarcoma

GGO:

Ground-glass opacities

HC:

Honeycomb cysts

HP:

Hypersensitivity pneumonitis

HPV:

Human papilloma virus

HRCT:

High-resolution computed tomography

LAM:

Lymphangioleiomyomatosis

LCDD:

Light chain deposition disease

LIP:

Lymphoid interstitial pneumonia

MMPH:

Multifocal micronodular pneumocyte hyperplasia

NSIP:

Nonspecific interstitial pneumonia

PJP:

Pneumocystis jiroveci pneumonia

PLCH:

Pulmonary Langerhans cell histiocytosis

RB:

Respiratory bronchiolitis

RRP:

Recurrent respiratory papillomatosis

SRIF:

Smoking-related interstitial fibrosis

References

  1. Hansell DM, Bankier AA, MacMahon H, McLoud TC, Muller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008;246(3):697–722.

    Article  Google Scholar 

  2. Smith M, Gotway M, Larsen B, Colby T, Tazelaar H, Leslie K. Pathologic approach to cystic lung disease. AJSP: Rev Rep. 2017;22(1):36–45.

    Google Scholar 

  3. Toro JR, Pautler SE, Stewart L, Glenn GM, Weinreich M, Toure O, et al. Lung cysts, spontaneous pneumothorax, and genetic associations in 89 families with Birt-Hogg-Dube syndrome. Am J Respir Crit Care Med. 2007;175(10):1044–53.

    Article  CAS  Google Scholar 

  4. Schneider F, Murali R, Veraldi KL, Tazelaar HD, Leslie KO. Approach to lung biopsies from patients with pneumothorax. Arch Pathol Lab Med. 2014;138(2):257–65.

    Article  Google Scholar 

  5. Kunogi M, Kurihara M, Ikegami TS, Kobayashi T, Shindo N, Kumasaka T, et al. Clinical and genetic spectrum of Birt-Hogg-Dube syndrome patients in whom pneumothorax and/or multiple lung cysts are the presenting feature. J Med Genet. 2010;47(4):281–7.

    Article  CAS  Google Scholar 

  6. Travis WD, Costabel U, Hansell DM, King TE Jr, Lynch DA, Nicholson AG, et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med. 2013;188(6):733–48.

    Article  Google Scholar 

  7. American Thoracic Society. European Respiratory Society international multidisciplinary consensus classification of the idiopathic interstitial pneumonias. This joint statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. Am J Respir Crit Care Med. 2002;165(2):277–304.

    Article  Google Scholar 

  8. Nicholson AG, Wotherspoon AC, Jones AL, Sheppard MN, Isaacson PG, Corrin B. Pulmonary B-cell non-Hodgkin’s lymphoma associated with autoimmune disorders: a clinicopathological review of six cases. Eur Respir J. 1996;9(10):2022–5.

    Article  CAS  Google Scholar 

  9. Kobashi Y, Sugiu T, Mouri K, Irei T, Nakata M, Oka M. Clinicopathological analysis of multifocal micronodular pneumocyte hyperplasia associated with tuberous sclerosis in Japan. Respirology. 2008;13(7):1076–81.

    PubMed  Google Scholar 

  10. Farinacci CJ, Jeffrey HC, Lackey RW. Eosinophilic granuloma of the lung; report of two cases. U S Armed Forces Med J. 1951;2(7):1085–93.

    CAS  PubMed  Google Scholar 

  11. Favara BE, Feller AC, Pauli M, Jaffe ES, Weiss LM, Arico M, et al. Contemporary classification of histiocytic disorders. The who committee on histiocytic/reticulum cell proliferations. Reclassification Working Group of the Histiocyte Society. Med Pediatr Oncol. 1997;29(3):157–66.

    Article  CAS  Google Scholar 

  12. Emile JF, Abla O, Fraitag S, Horne A, Haroche J, Donadieu J, et al. Revised classification of histiocytoses and neoplasms of the macrophage-dendritic cell lineages. Blood. 2016;127(22):2672–81.

    Article  CAS  Google Scholar 

  13. Arnaud L, Pierre I, Beigelman-Aubry C, Capron F, Brun AL, Rigolet A, et al. Pulmonary involvement in Erdheim-Chester disease: a single-center study of thirty-four patients and a review of the literature. Arthritis Rheum. 2010;62(11):3504–12.

    Article  Google Scholar 

  14. Colby TV, Lombard C. Histiocytosis X in the lung. Hum Pathol. 1983;14(10):847–56.

    Article  CAS  Google Scholar 

  15. Travis WD, Borok Z, Roum JH, Zhang J, Feuerstein I, Ferrans VJ, et al. Pulmonary Langerhans cell granulomatosis (histiocytosis X). A clinicopathologic study of 48 cases. Am J Surg Pathol. 1993;17(10):971–86.

    Article  CAS  Google Scholar 

  16. Gupta N, Colby TV, Meyer CA, McCormack FX, Wikenheiser-Brokamp KA. Smoking-related diffuse cystic lung disease. Chest. 2018;154(2):e31–e5.

    Article  Google Scholar 

  17. Baqir M, Kluka EM, Aubry MC, Hartman TE, Yi ES, Bauer PR, et al. Amyloid-associated cystic lung disease in primary Sjogren’s syndrome. Respir Med. 2013;107(4):616–21.

    Article  Google Scholar 

  18. Colombat M, Gounant V, Mal H, Callard P, Milleron B. Light chain deposition disease involving the airways: diagnosis by fibreoptic bronchoscopy. Eur Respir J. 2007;29(5):1057–60.

    Article  CAS  Google Scholar 

  19. Bhargava P, Rushin JM, Rusnock EJ, Hefter LG, Franks TJ, Sabnis SG, et al. Pulmonary light chain deposition disease: report of five cases and review of the literature. Am J Surg Pathol. 2007;31(2):267–76.

    Article  Google Scholar 

  20. Desai SR, Nicholson AG, Stewart S, Twentyman OM, Flower CD, Hansell DM. Benign pulmonary lymphocytic infiltration and amyloidosis: computed tomographic and pathologic features in three cases. J Thorac Imaging. 1997;12(3):215–20.

    Article  CAS  Google Scholar 

  21. Chew KM, Clarke MJ, Dubey N, Seet JE. Nodular pulmonary amyloidosis with unusual, widespread lung cysts. Singap Med J. 2013;54(5):e97–9.

    Article  Google Scholar 

  22. Ohdama S, Akagawa S, Matsubara O, Yoshizawa Y. Primary diffuse alveolar septal amyloidosis with multiple cysts and calcification. Eur Respir J. 1996;9(7):1569–71.

    Article  CAS  Google Scholar 

  23. Arrossi AV, Merzianu M, Farver C, Yuan C, Wang SH, Nakashima MO, et al. Nodular pulmonary light chain deposition disease: an entity associated with Sjogren syndrome or marginal zone lymphoma. J Clin Pathol. 2016;69(6):490–6.

    Article  CAS  Google Scholar 

  24. Khoor A, Colby TV. Amyloidosis of the lung. Arch Pathol Lab Med. 2017;141(2):247–54.

    Article  Google Scholar 

  25. Seaman DM, Meyer CA, Gilman MD, McCormack FX. Diffuse cystic lung disease at high-resolution CT. AJR Am J Roentgenol. 2011;196(6):1305–11.

    Article  Google Scholar 

  26. Abrams J, Talcott J, Corson JM. Pulmonary metastases in patients with low-grade endometrial stromal sarcoma. Clinicopathologic findings with immunohistochemical characterization. Am J Surg Pathol. 1989;13(2):133–40.

    Article  CAS  Google Scholar 

  27. Aubry MC, Myers JL, Colby TV, Leslie KO, Tazelaar HD. Endometrial stromal sarcoma metastatic to the lung: a detailed analysis of 16 patients. Am J Surg Pathol. 2002;26(4):440–9.

    Article  Google Scholar 

  28. Hill DA, Jarzembowski JA, Priest JR, Williams G, Schoettler P, Dehner LP. Type I pleuropulmonary blastoma: pathology and biology study of 51 cases from the international pleuropulmonary blastoma registry. Am J Surg Pathol. 2008;32(2):282–95.

    Article  Google Scholar 

  29. Hoag JB, Sherman M, Fasihuddin Q, Lund ME. A comprehensive review of spontaneous pneumothorax complicating sarcoma. Chest. 2010;138(3):510–8.

    Article  Google Scholar 

  30. Ioachimescu OC, Sieber S, Walker MJ, Rella V, Kotch A. A 35-year-old woman with asthma and polycystic lung disease. Chest. 2002;121(1):256–60.

    Article  Google Scholar 

  31. Odev K, Guler I, Altinok T, Pekcan S, Batur A, Ozbiner H. Cystic and cavitary lung lesions in children: radiologic findings with pathologic correlation. J Clin Imaging Sci. 2013;3:60.

    Article  Google Scholar 

  32. Tateishi U, Hasegawa T, Kusumoto M, Yamazaki N, Iinuma G, Muramatsu Y, et al. Metastatic angiosarcoma of the lung: spectrum of CT findings. AJR Am J Roentgenol. 2003;180(6):1671–4.

    Article  Google Scholar 

  33. Traweek T, Rotter AJ, Swartz W, Azumi N. Cystic pulmonary metastatic sarcoma. Cancer. 1990;65(8):1805–11.

    Article  CAS  Google Scholar 

  34. Gupta N, Vassallo R, Wikenheiser-Brokamp KA, McCormack FX. Diffuse cystic lung disease. Part I. Am J Respir Crit Care Med. 2015;191(12):1354–66.

    Article  Google Scholar 

  35. Farooqi AO, Cham M, Zhang L, Beasley MB, Austin JH, Miller A, et al. Lung cancer associated with cystic airspaces. AJR Am J Roentgenol. 2012;199(4):781–6.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Duke University Medical Center, Durham, NC, USA

    John M. Carney

  2. Department of Pathology and Laboratory Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA

    Maxwell L. Smith

Authors
  1. John M. Carney
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maxwell L. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maxwell L. Smith .

Editor information

Editors and Affiliations

  1. University of Cincinnati, Cincinnati, OH, USA

    Nishant Gupta

  2. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Kathryn A. Wikenheiser-Brokamp

  3. University of Cincinnati, Cincinnati, OH, USA

    Francis X. McCormack

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Carney, J.M., Smith, M.L. (2021). Pathological Evaluation of Pulmonary Cysts. In: Gupta, N., Wikenheiser-Brokamp, K.A., McCormack, F.X. (eds) Diffuse Cystic Lung Diseases. Respiratory Medicine. Humana, Cham. https://doi.org/10.1007/978-3-030-63365-3_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-63365-3_4

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-63364-6

  • Online ISBN: 978-3-030-63365-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation