Image of the month: Placental transmogrification of the lung: a rare cause of cystic lung disease

摘要

A 40-year-old woman, who was an ex-smoker, presented with a 2-month history of dry cough, and sensation of fluid movement within the thorax. Past medical history included only liver haemangiomas, for which she was under surveillance. Computed tomography (CT) of the thorax, axial image of lung and soft tissue, demonstrated a large thin-walled fluid collection in the region of the right major fissure. The collection extended into the right paracardiac and posterior mediastinal regions. Lung adjacent to this was atelectatic, but the remaining parenchyma was normal (Fig ​(Fig1).1). The patient underwent further investigation under the cardiothoracic team with right diagnostic video-assisted thoracoscopic surgery. This showed three thin walled cystic lesions, containing both fluid and air, arising from the lung parenchyma. The fluid was aspirated and analysis revealed it to be predominantly lymphocytic, comprising small lymphocytes and foamy macrophages. No organisms, ova or parasites were seen. Routine blood tests, blood-borne virus screen and autoimmune panel were unremarkable. The patient mentioned recent travel to Africa, subsequently infectious/tropical diseases were ruled out after performing the appropriate laboratory tests.