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高雄長庚醫院 胸腔內科
曾嘉成醫師
Cavity and Cyst
Cavity: a gas containing space
within the lung surrounded by
a wall whose thickness is
greater than 1 mm.
4-15 mm inconclusive.
– Smooth
Differential Diagnosis
(3)
Nature of the Cavitary
Content:
– Fluid: in most cases, the
contents are liquid.
– Fungus ball.
– Pulmonary gangrene: irregular
pieces of sloughed necrotic lung
parenchyma float like icebergs
in the cavity fluid.
– Water-lily sign: ruptured
Differential Diagnosis
(4)
Associated Lesions:
– Surrounding air space
consolidation: acute edema,
hemorrhage, exudate.
Nocardia
Coccidioidomycosis
Coccidioidomycosis
Hydatid Cyst
Echinococcus, a parasite
3 layers of hydatid cyst
– Outer: tough pericyst, produced by host
– Middle: laminated layer, produced by parasite
– Inner: unicellular, germinal layer, produce fluid
and cyst
Spherical, well-defined, homogenous cyst
growing and asymptomatic until rupture
Water-lily sign: air entering outer and
middle layer
cyst fragment floating in the cavity
Cavity: Neoplasm (1)
Primary lung cancer:
– epidermoid ca.; bronchioloalveolar cell ca.
Metastatic cancer: (NPC,Eso. Ca,Cx Ca)
– Man: head and neck in origin.
– Woman: Gyn. tract in origin.
Invariably transient
Mechanism:
– check valve obstruction of the airways
– Subpleural collection of air, dissection occurs
through the interstitium of the lung
Staph. pneumonia with
pneumatocele
Bulla (1)
A sharp demarcated, air
containing space 1 cm or
more in diameter that
possess a smooth wall 1 mm
or less in thickness.
Usually occurs with other lung
disease (emphysema or
infection).
由 infection 引起者,常伴有
Bulla (2)
Secondary Sign: compression
or displacement of adjacent
structures (lung and
mediastinum).