Fourteen-year-old girl with multifocal complex cysts in the right lung

A 14-year-old girl was diagnosed with pectus excavatum at birth and underwent corrective surgery at the age of 4. Preoperative chest CT scan incidentally revealed multiple cystic lesions in the right upper and middle lobes (figure 1A), which were not specifically addressed at that time. Since the age of 7, she experienced reduced exercise tolerance. Over the past 6 months, she presented with intermittent fever, cough and haemoptysis. The patient was referred to our hospital for further evaluation and management. Physical examination revealed significantly reduced breath sounds in the right lung compared with the left. No clubbing was observed. A chest CT scan revealed that, compared with 10 years ago, the cysts in the right upper and middle lobes had increased in size. The largest lesions, originally two adjacent cysts, had merged into a single cyst, growing from 21.5×33.8×21.0 mm to 60.2×56.9×70.6 mm, with multifocal solid masses appearing within the merged cyst (figure 1). Serum Aspergillus fumigatus -specific IgG antibody was positive, and tests for tuberculosis and HIV were negative. Immunological function was normal. Figure 1 Chest CT demonstrating significant growth of the cystic lesions over 10 years. (A) A chest CT scan at age 4 revealed multiple cystic lesions in the right upper …