0:01

So let's wrap up.

0:02

So we have our four choices for differential diagnosis

0:06

for diffuse cystic lung disease at most centers.

0:09

And so remember lamb, we're talking about thin walled,

0:12

pretty cyst, diffuse distribution round

0:14

and oval intervening.

0:15

Lung should be normal. Remember lamb can be either related

0:20

to tube sclerosis

0:22

or it can come, um, without

0:24

that underlying disease abnormality.

0:27

And so in both these cases, you're gonna look for angio,

0:29

my lipomas in the upper abdomen.

0:30

Even in patients who have isolated lam

0:33

and not TS related lam,

0:34

they can still get angio myel lipomas.

0:37

Every once in a while you're gonna see some scattered subs,

0:40

solid nodules throughout the lungs, usually subs solid,

0:42

very small and often oftentimes innumerable.

0:46

And so in the setting of lamb, you should be thinking,

0:48

especially TS lamb.

0:49

You should be thinking about multifocal micro nodular

0:51

pneumococci hyperplasia.

0:53

Some people would just call it pneumococci hyperplasia,

0:55

but we can see those as well.

0:57

Uh, probably worth following them at least a little bit

0:59

to make sure that there's no adenocarcinoma in any

1:02

of these more dominant nodules.

1:05

TLCH, we talked about that.

1:06

It's just completely different from the other, uh,

1:07

diffuse cystic lung disease.

1:09

So the cytal walls can be thin

1:11

or thick, they're ugly, they're upper lung preponderant.

1:14

They spare the schizophrenic angles can be oftentimes

1:17

bizarre shaped, very, very different.

1:19

And heterogeneous, remember

1:21

that they emanate from those central lo nodules.

1:24

And you should be looking

1:25

for these cheerios like small cavitary

1:27

nodules and an end stage.

1:28

They can give you this burnt out appearance,

1:30

that complex pattern of some upper lung preponderant,

1:33

fibrosis, emphysema, diffuse cystic lung disease,

1:37

and sometimes some scattered central lobular nodules.

1:40

So pretty specific for P-P-L-C-H.

1:42

Again, if there's that relative basal sparing in somewhat

1:46

strong smoking related history, LIP.

1:49

In adults, we're gonna see that most common Sjogren's

1:51

syndrome and sometimes even deficiencies.

1:53

These are basar predominant cyst. They're pretty cysts.

1:56

Look for peron ster and subpleural cyst.

1:58

Um, every once in a while you're gonna see some concomitant

2:01

inflammation, but in my

2:02

clinical practice, that's not that common.

2:04

LIP and bird hug debate look very similar.

2:06

Bird Hug Bay also gives you thin walled cyst.

2:08

But remember, look for those renal tumors.

2:10

So bird hug debase syndrome also predispose you

2:13

to renal tumors, renal cell carcinomas and oncocytoma.

2:17

And then for bird hug debase syndrome.

2:20

The per mediastinals are quite characteristic.

2:23

Thank you very much. I.