The differential diagnosis is between Langerhans cell histiocytosis and lymphangiomyomatosis.
Does this CT slice help?
This shows a predominant cystic pattern, with bizarre and odd shapes to the cysts. A few nodules are seen. Elsewhere on the CT, the bases were spared. She had previously had an open biopsy.
The diagnosis is Langerhans cell histiocytosis (LCH).
Key learning points:
- early in the disease nodules predominate, later it is cysts
- typical demographic: 20-40 year old females
- sparing of extreme bases
- lung volumes preserved
- bizarre shape to cysts (round and regular in LAM)