Article Text

PDF
Original article
Pulmonary cysts identified on chest CT: are they part of aging change or of clinical significance?
  1. Tetsuro Araki1,
  2. Mizuki Nishino1,
  3. Wei Gao2,
  4. Josée Dupuis2,3,
  5. Rachel K Putman4,
  6. George R Washko4,
  7. Gary M Hunninghake4,
  8. George T O'Connor3,5,
  9. Hiroto Hatabu1
  1. 1Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
  3. 3The National Heart Lung and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA
  4. 4The Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
  5. 5Pulmonary Center and Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
  1. Correspondence to Dr Tetsuro Araki, Department of Radiology, Center for Pulmonary Functional Imaging, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02215, USA; taraki{at}partners.org

Abstract

Objective To investigate the prevalence and natural course of pulmonary cysts in a population-based cohort and to describe the CT image characteristics in association with participant demographics and pulmonary functions.

Materials and methods Chest CT scans of 2633 participants (mean age 59.2 years; 50% female) of the Framingham Heart Study (FHS) were visually evaluated for the presence of pulmonary cysts and their image characteristics. These findings were correlated with participant demographics and results of pulmonary function tests as well as the presence of emphysema independently detected on CT. The interval change was investigated by comparison with previous CT scans (median interval 6.1 years).

Results Pulmonary cysts were seen in 7.6% (95% CI 6.6% to 8.7%; 200/2633). They were not observed in participants younger than 40 years old, and the prevalence increased with age. Multiple cysts (at least five) were seen in 0.9% of all participants. Participants with pulmonary cysts showed significantly lower body mass index (BMI) (p<0.001). Pulmonary cysts were most likely to appear solitary in the peripheral area of the lower lobes and remain unchanged or slightly increase in size over time. Pulmonary cysts showed no significant influence on pulmonary functions (p=0.07–0.6) except for diffusing capacity of the lung for carbon monoxide (DLCO) (p=0.03) and no association with cigarette smoking (p=0.1–0.9) or emphysema (p=0.7).

Conclusions Pulmonary cysts identified on chest CT may be a part of the aging changes of the lungs, occurring in asymptomatic individuals older than 40 years, and are associated with decreased BMI and DLCO. Multiple pulmonary cysts may need to be evaluated for the possibility of cystic lung diseases.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.