A 38-Year-Old Woman With Bilateral Cystic Lesions in Both Lower Lung Lobes

Abstract

A 38-year-old woman visited our clinic because of intermittent nonproductive cough for several months. Her past medical history revealed no specific illness. She was a nonsmoker. On physical examination, her breath sounds were decreased on both lower lung fields. Laboratory tests revealed a leukocyte count of 8,540/μL with 74.2% neutrophils, erythrocyte sedimentation of rate 66 mm/h, and high sensitivity C-reactive protein level of 26.47 mg/L, and were otherwise normal. After reviewing the chest imaging, several diagnostic approaches were performed to define the possible causes for the cystic mass lesions, such as infections, malignancy, immunologic diseases, and embolism. There was no definitive endobronchial lesion on bronchoscopic examination, and bronchial washing was negative for malignancy. BAL cultures were negative for bacteria, Mycobacterium, virus, and fungi. Clinical assessment of the progress and response of the cystic lesions to the antibiotics revealed that there were no definitive infectious, immunologic, or malignant causes. We decided to remove the cystic lesions via surgical resection because there was no response to medical treatment, and the tissues were analyzed for diagnosis. After she received the final diagnosis pathologically, at 2-month follow-up, she had no complaints, and no evidence of the disease was found.