Pneumatocysts are air-filled cysts that can develop in the lungs or other parts of the body due to infections, chemical exposure, autoimmune disease, or trauma. Diagnosis is through X-ray and treatment involves addressing the underlying cause and providing symptomatic relief. In severe cases, surgical intervention may be necessary.
A pneumatocele, or pneumatocyst, is an air- or gas-filled cyst that most often develops within the lung tissue. However, pneumocele formation can occur in other regions of the body, including the brain. Pneumatocysts can occur singly but more often form in clusters. Infections, chemical exposure, or autoimmune disease can induce the condition, and trauma can be a contributing factor. Medical intervention generally involves treating the underlying condition and providing symptomatic relief.
Doctors have different opinions on the physiology of pneumatocele formation. Some suggest that the inflammation causes the bronchioles to become blocked, forcing air down into an alveolus. The increased pressure ruptures the alveolar lumen, creating an air pocket. Pneumatocysts in the outer areas of the lung can form when the bronchiolar lumen becomes inflamed, creating a passage for air to escape. The increased pressure eventually causes tissue to bulge outward into the pleura.
Studies suggest that in most cases a pulmonary pneumatocele forms secondary to a bacterial infection. Reports indicate that when the condition does appear in young children and infants, it is due to bacterial infections over 70% of the time. Fungal or viral infections can also cause the development of pneumatoctists. A respiratory infection can progress from fever and cough to painful breathing.
Aspiration or inhalation of certain chemicals, including petroleum products, often lead to inflammation and subsequent development of lung cysts. The inflammation that accompanies the autoimmune disorders lupus or rheumatoid arthritis can also lead to the development of pneumatoceles. Cysts that form in the brain or other organs could be caused by infections, malignancies, or trauma.
Chest trauma can also contribute to pneumatocele formation. Traumatic pneumatocele formation can occur as a result of initial external blunt force or rebound motion of internal tissues. External and internal pressures can crush, cut, and tear tissue, leading to both ruptures and pneumatocysts. Treatment largely depends on the extent of internal injuries and disruption of normal air exchange.
Positive diagnosis of a pneumatocele usually requires an X-ray. Samples of pleural fluid, sputum, or urine can be used to identify the responsible microbe. Once the organism is identified, anti-infective drugs may be prescribed. A pneumatocele that results from toxin exposure can also be treated with steroids and pain relievers to control inflammation and pain. Follow-up monitoring usually ensures resolution of the infection and associated pneumatocyst.
With the exception of traumatic injuries, most pneumatoceles resolve once a patient receives treatment for the underlying cause. Medical intervention usually involves more drastic measures when the formation of pulmonary pneumatocysts involves large areas of lung tissue, impedes breathing or threatens cardiovascular circulation. Doctors can deflate the cysts using a syringe or surgically insert catheters. In rare cases, surgeons perform surgical resection, which removes the affected tissue.
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