History: 34 yo with shortness of breath.
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So this comes down to 2 causes of cystic lung disease: LAM (lymphangioleimyomatosis) and the pulmonary manifestations of LCH (Langerhan’s cell Histiocytosis).
- thin walled cysts of varying size surrounded by normal lung parenchyma
- dilated thoracic duct (chylothorax)
- nodules and/or cysts that are irregular in shape with thick walls
- sparring of lower lungs and costophrenic angles
- younger patient (20-40) with history of smoking
Answer: pulmonary LCH
nice comparison: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841705/