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Air filled, inflammatory, lung pseudo-cyst: etio-pathogenesis and management

Nishith Kumar Jetley1, Mahmoud Rezk Abd El-Wahed Hussein, Abdul Lateef Softha

  • 1Department of Pediatric Surgery, Assir Central Hospital, Abha, Saudi Arabia. nkjetley@hotmail.com

Indian Journal of Pediatrics
|April 7, 2009
PubMed

Insights

Acquired lung cysts in children, often congenital, can present as pneumothorax. This case highlights an inflammatory pseudocyst, diagnosed via immunohistochemistry, expanding differential diagnoses for pediatric lung lesions.

Area of Science:

  • Pediatric Pulmonology
  • Thoracic Surgery
  • Pathology

Background:

  • Congenital lung cysts are common in children.
  • Acquired cysts can result from infections, trauma, cystic fibrosis, or poisoning.
  • Pneumothorax in children necessitates investigation for underlying lung pathology.

Observation:

  • A child presented with pneumothorax, revealing a right lung cyst.
  • Surgical resection and histological examination identified an inflammatory pseudocyst lacking epithelial lining.
  • Immunohistochemical staining confirmed predominant histiocytes (CD68 positive) in the cyst wall.

Findings:

  • The pseudocyst wall stained negative for S-100, cytokeratins, and smooth muscle actins.
  • These negative markers excluded diagnoses such as Langerhans cell histiocytosis, epithelial cysts, and congenital cysts.
  • The findings indicate an acquired pulmonary pseudocyst of inflammatory origin.

Implications:

  • This case expands the understanding of acquired pulmonary pseudocysts in children.
  • Pulmonary pseudocysts should be considered in the differential diagnosis of pediatric pneumothorax.
  • Further research may elucidate the specific etiologic agents for such acquired pseudocysts.

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