Tuberc Respir Dis.  2009 Nov;67(5):467-470.

A Case of Post-Traumatic Pulmonary Pseudocyst Mimicking Pulmonary Cavitary Tuberculosis

• Lee HJ
• Kang JY
• Yim SM
• Ji EH
• Kim JH
• Kim SW
• Lee SH
• Moon HS
• Lee BY

Abstract

A traumatic pulmonary pseudocyst is a rare complication of blunt thoracic trauma. The clinical symptoms and signs are similar to other respiratory diseases, such as pulmonary tuberculosis. Therefore, a trauma history with the resulting radiologic and clinical findings is important for making a diagnosis. A 26-year-old male was admitted to our hospital due to cough for 3 days. The chest x-ray revealed diffuse infiltrations and a cavitary lesion at the left lung. His left chest had hit a tree as a result of motorcycle accident one day before admission. Initially, it was assumed that his symptoms and chest X-ray might be due to a tuberculosis infection. However, bronchoscopy revealed old blood clots at both lungs, particularly in the left lower lobe bronchus. A transbronchial lung biopsy showed alveolar hemorrhage. A traumatic pulmonary pseudocyst was diagnosed from his trauma history and these findings. Computed tomography of the chest performed 4 months later showed regression of the cavitary lesion.

Keyword

Lung Injury; Cysts; Wounds and Injuries; Cavity

MeSH Terms

Adult
Biopsy
Bronchi
Bronchoscopy
Cough
Hemorrhage
Humans
Lung
Lung Injury
Male
Motorcycles
Thorax
Tuberculosis
Tuberculosis, Pulmonary

Figure

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  Figure 1 Initial posteroanterior chest X-ray shows ill-defined ground glass opacity and cavitary change in left lung field.

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  Figure 2 Computed tomography image with a lung window setting shows clustered small and large cavitary lesions with wall thickening in left lower lobe, predominantly superior segment.

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  Figure 3 Flexible bronchoscopy shows old blood clot from trachea to both main bronchus, predominantly in left lower lobe bronchus.

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  Figure 4 Microscopic finding shows intra-alveolar hemorrhage, deposit of fibrinoid fluid and focal infiltration of neutrophils (H&E stain, ×).

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  Figure 5 Follow up chest computed tomography performed 4 months later shows much regression of the previously noted cavitary and infiltrative lesion.

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