Sir,
I read with interest the review article “Diffuse cystic lung diseases: Imaging spectrum and diagnostic approach using high-resolution computed tomography” by Singh et al.[1] The diagnostic approach explained was very relevant and useful for clinicians during evaluation of such a patient. But I have the following points to offer:
- Tuberculosis can present as diffuse cystic lung disease.[2–4] Though such presentation is very rare, being a high tuberculous burden country, Indian algorithm for diffuse cystic lung disease would benefit from including the disease, as it is a potentially reversible cause of lung cysts.[4]
- Cystic lung diseases are prone to develop pneumothorax. A computed tomography (CT) during a pneumothorax would lead to missed parenchymal findings of the ipsilateral collapsed lobe/lung and those findings could be critical in clinching the diagnosis. So, patients with such diffuse cystic lung disease should have a repeated CT after the drainage of pneumothorax.
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Conflicts of interest
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REFERENCES
1. Singh P, Verma AK, Pandey G. Diffuse cystic lung diseases:Imaging spectrum and diagnostic approach using high-resolution computed tomography. Lung India 2022;39:553–61.
2. Ray A, Suri JC, Sen MK, Khanna A. Cystic lung disease in tuberculosis:An unusual presentation. Lung India 2013;30:351–3.
3. Kodati R, Tadepalli A, Reddy C. Pulmonary tuberculosis presenting as diffuse cystic lung disease:An atypical manifestation. Indian J Tuberc 2020;67:397–9.
4. Van LD, Le HN, Pletschette M, Nguyen AT, Nguyen TH, Nguyen NBT. Cystic pulmonary tuberculosis: A rare form of an ancient disease. Respir Case Rep 2022;10:e01020. doi: 10.1002/rcr2.1020.
