Massive reversible pulmonary cysts in a patient with AIDS

Abstract

SummaryWe report the case of a patient with AIDS who presented with bilateral, massive pulmonary cystic disease and pneumothorax presumably caused by Pneumocystis carinii which responded to treatment with cotrimoxazole. Follow-up with sequential chest X-rays and computed tomography scans showed a progressive improvement in the lung cysts which had resolved almost completely 11 months later. Several theories have been proposed to explain the cavitary lesions in this infection. The course observed in our patient suggests that a non-destructive mechanism was responsible for his lung cysts.

A case of spontaneous pneumothorax, pneumomediastinum & subcutaneous emphysema in Pneumocystis jirovecii pneumonia complicating HIV

“…Reports also suggest that some of the changes may even be reversible with treatment. 18 The cysts are typically apical and subpleural, lined by fibrosis and/or alveolar parenchyma with little inflammation in the acute stage. Necrotizing, thin-walled, smaller intraparenchymal cavities lined by organisms, exudate and chronic inflammation can also be seen.…”