Guler, Sevim

AbstractDiffuse cystic lung diseases (DCLDs) are a diverse group of lung disorders characterized by the presence of multiple air filled cysts within the lung tissue. These cysts are thin walled and surrounded by normal lung tissue. In adults, DCLD can be associated with various conditions such as lymphangioleiomyomatosis (LAM), Langerhans cell histiocytosis, cancers, and more. In children, DCLD is often linked to lung developmental abnormalities, with bronchopulmonary dysplasia being a common cause. Patients with pulmonary cysts are typically asymptomatic, but some may experience mild symptoms or pneumothorax. While DCLD in children is rarely due to malignancy, metastatic lung disease can be a cause. It is important for clinicians to be aware of the possibility of metastatic lung disease when encountering DCLD.

We are presenting a teenage girl with a recent history of virilism who presented with tension pneumothorax. Subsequent contrast-enhanced chest CT revealed multiple bilateral irregular thin-walled cysts of varying sizes with numerous solid noncalcified pulmonary nodules and pulmonary artery pseudoaneurysms. Lung biopsy revealed trophoblastic neoplasm with metastasis to both lungs. We discussed the differential diagnosis of diffuse cystic lung diseases. While diffuse cystic lung diseases in children are rarely due to malignancy, we emphasize that clinicians be aware of the possibility of metastatic lung diseases and their radiologic features when encountering diffuse cystic lung diseases.