WorksheetsCystic Lung Diseases Quiz
Total questions: 69
Worksheet time: 35mins
Which of the following best describes cystic lung diseases (CLDs)?
A heterogeneous group of pathophysiological entities comprising gas-filled lesions with imperceptible walls throughout the lung parenchyma.
Diseases characterized by solid tumors in the lungs.
A group of infectious diseases affecting only the upper respiratory tract.
A type of lung disease caused exclusively by bacterial infections.
What is an essential tool in the evaluation of cystic lung diseases (CLDs)?
High-resolution computed tomography (HRCT)
Electrocardiogram (ECG)
Blood glucose test
Spirometry
Which of the following is NOT considered a pulmonary lucency separate from cysts according to the Fleischner Society criteria?
Fibrous wall
Pneumatoceles
Emphysema
Honeycombing
What is the defining feature of a pulmonary cyst as seen on radiographs or HRCT?
A gas-filled round or irregularly shaped parenchymal transparency/low-attenuating area with a thin wall (<3 mm)
A solid mass with a thick wall (>5 mm)
A calcified nodule with a spiculated margin
A fluid-filled cavity with a thick, irregular wall
Why is a multidisciplinary approach important in the evaluation of cystic lung diseases?
Because CLDs may be associated with many different processes and require comprehensive diagnostic strategies.
Because only radiologists can diagnose CLDs.
Because CLDs are always caused by infections.
Because treatment always requires surgery.
What is emphysema defined as?
A permanent enlargement of alveolar spaces with disruption of septa and compression of surrounding parenchyma.
A temporary inflammation of the bronchioles.
A reversible narrowing of the airways.
A buildup of fluid in the pleural cavity.
Which of the following is NOT a form of cyst aetiology mentioned in the text?
Check-valve obstruction by proliferation of smooth muscle cells
Ischaemia
Remodeling induced by matrix metalloproteinases
Viral infection of alveolar cells
Which imaging finding is associated with pulmonary fibrosis seen in severe interstitial lung disease?
Honeycombing
Pneumatocele
Cavitated tumour
Pleural effusion
What is the main difference between cysts and other solid organs according to the text?
Cysts do not develop simple structures like solid organs.
Cysts are always filled with fluid.
Cysts are only found in the liver.
Cysts are always cancerous.
Which diagnostic steps are recommended for patients with suspected lung disease?
Complete history, physical examination, laboratory tests, and CXR
Only a physical examination
Only laboratory tests
Only a CT scan
Figure 1: HRCT in axial view shows round scattered thin-walled cysts and normal-appearing intervening lung.
Lymphangioleiomyomatosis (LAM)
Pulmonary edema
Pleural effusion
Bronchial carcinoma
Figure 2: (a) Large bulla in the left upper lobe, (b) Honeycombing with cystic air spaces, (c) Cystic bronchiectasis, (d) Cavitated tumour with irregular, thick wall.
Different types of cystic and cavitary lung lesions
Normal lung anatomy
Cardiac MRI images
Abdominal CT scans
Which of the following is a biomarker that may be useful for the diagnosis of cystic lung diseases?
Vascular endothelial growth factor D (VEGF-D)
Hemoglobin A1c
C-reactive protein
Troponin T
What is the main difference between cystic diseases and mimicking cyst-like lesions such as emphysema and bronchiectasis?
Cystic diseases have relatively well-defined cysts
Cystic diseases always involve infection
Cystic diseases are only found in children
Cystic diseases are always cancerous
According to the text, what is the typical location for solitary cysts in the lung?
Peripheral aspect of the lower lobes
Central aspect of the upper lobes
Middle of the trachea
Near the diaphragm
Which syndrome is associated with cysts that are either lobulate or multiloculate?
Birt–Hogg–Dubé (BHD) syndrome
Sjögren’s syndrome
Langerhans cell histiocytosis
Pneumocystis jiroveci pneumonia
What does the term "focal disease" refer to in the context of cystic lung diseases?
More than one cyst in one lung lobe
Cysts in all lobes of both lungs
Cysts only in the trachea
Cysts that are always fluid-filled
Which of the following best describes the distribution of cysts in Langerhans cell histiocytosis (PLCH)?
Upper and middle lung involvement with sparing of bases and costophrenic sulci
Lower lobe predominance only
Central tracheal involvement
Diffuse involvement of all lobes equally
Which imaging technique is referenced in the figure for identifying cystic lung diseases?
High-resolution computed tomography (HRCT)
Magnetic resonance imaging (MRI)
Ultrasound
X-ray fluoroscopy
What is a characteristic feature of cysts in pulmonary Langerhans cell histiocytosis (PLCH)?
Thick and irregular walls
Always fluid-filled
Only found in the lower lobes
Never associated with ground-glass opacity
Which of the following statements about cyst size in cystic lung diseases is correct?
Cyst size can be uniform or variable and ranges from 2 mm to >80 mm
Cyst size is always less than 5 mm
Cyst size does not affect diagnosis
Cyst size is only important in children
What is the significance of vessels traversing the cysts or their walls in LCCD?
It is a characteristic feature of LCCD
It indicates infection
It is only seen in cancerous cysts
It is not relevant to diagnosis
Which of the following is classified as an age-related lung cystic disease?
Lymphangioleiomyomatosis (LAM)
Desquamative interstitial pneumonia (DIP)
Ageing lung
Pulmonary Langerhans cells histiocytosis (PLCH)
What is the defining feature of a cyst as described in Table 2?
A permanently enlarged airspace distal to the terminal bronchiole without a wall
A round parenchymal lucency interfaced with normal lung thin wall (<2 mm)
A gas-filled space within consolidation, a mass or a nodule
An airspace (>1 cm) with a round focal lucency, bounded by a thin wall (<1 mm)
Which hereditary condition is associated with lung cystic diseases?
Pulmonary Langerhans cells histiocytosis (PLCH)
Trisomy 21
Amyloidosis
Tuberculosis
According to the text, what is the typical wall thickness of a bulla?
Less than 1 mm
More than 2 mm
3–10 mm
Less than 2 mm
Which of the following statements best describes the difference between a cyst and an emphysema as per Table 2?
Both have thick walls and are associated with infection.
Cysts have a thin wall and are round, while emphysema is a permanently enlarged airspace without a wall.
Emphysema is a gas-filled space within a mass, while cysts are always subpleural.
Cysts are always associated with honeycombing, while emphysema is not.
Which finding is commonly associated with Lymphangioleiomyomatosis (LAM) in extra-thoracic imaging?
Chylous pleural effusion
Hepatic and renal angiomyolipomas (AMLs)
Bronchogenic lung cysts
Amyloidosis
Which of the following is NOT a feature of honeycombing as described in Table 2?
Subpleural, multiple cystic cluster
Typically 3–10 mm in diameter
Suggestive of end-stage lung disease
A gas-filled space within a mass or nodule
In the context of intra-thoracic imaging, what does the presence of nodules and cysts together suggest?
Only amyloidosis
Only LCDD
Both amyloidosis and LCDD
Only PLCH
Which of the following is a common finding in LAM, BHD, and PLCH, but less common in PJP?
Pneumatocele
Pneumothorax
Bulla
Cavity
Which of the following is NOT listed as a cause of focal pulmonary lucencies on HRCT without true cystic lesions?
Emphysema
Honeycomb
LAM
Pneumatocele
According to the diagram, which disease is associated with multifocal cysts on HRCT?
LAM
LIP
PLCH
Amyloidosis
Which of the following is a possible HRCT associated sign when cysts are present and ground-glass opacities (GGO) are observed?
LIP
PLCH
BHD
Emphysema
What is the most common renal finding in patients with BHD syndrome?
Benign cysts
Papillary renal carcinoma
Hybrid chromophobe oncocytomas
Clear cell carcinoma
Which of the following statements best describes the renal lesions in BHD syndrome?
They are always unilateral and benign.
They are often bilateral and multifocal.
They are only malignant.
They are only found in children.
What is the typical morphology of cysts in folliculin gene-associated BHD as seen on HRCT?
Thin-walled cysts of varying sizes, often along the subpleural region
Thick-walled cysts with central calcification
Solid nodules with irregular borders
Diffuse ground-glass opacities
Which of the following is a common cutaneous manifestation in patients with BHD syndrome?
Fibrofolliculomas
Cafe au lait spots
Eczema
Brown papules
What is the typical wall thickness of cysts associated with neoplasms?
1–4 mm
5–10 mm
10–15 mm
0.1–0.5 mm
Which mechanism is NOT mentioned as a cause for cyst formation in the lungs?
Central necrosis with expulsion of necrotic debris
Check valve effects
Progressive diffuse or nodular thickening of the cystic wall
Increased blood flow to the alveolar sacs
What does Figure 6 primarily demonstrate?
Round distinct thin-walled cystic airspaces
Thickened pleural membranes
Large solid lung masses
Bronchial wall calcification
Which of the following statements best describes the “whirl-sign” or “waterlily sign” seen in imaging of a ruptured hydatid cyst?
Floating detached membranes in a thick-walled cyst with minimal pleural effusion
Solid mass with central necrosis
Diffuse alveolar thickening
Nodular calcification of the cyst wall
Cysts and cavitations of varying degrees may be a rare complication of which recent viral pneumonia?
SARS-CoV-2 pneumonia (COVID-19)
Influenza A pneumonia
Tuberculosis
Varicella pneumonia
Which type of tumor is more frequently associated with cystic metastases in the lungs?
Tumors of epithelial origin
Bone tumors
Lymphomas
Melanomas
What is the significance of the “ball-valve” effect as seen in HRCT imaging?
It predicts the formation of a thin-walled cyst due to airway obstruction.
It indicates the presence of a solid tumor.
It shows the presence of pleural effusion.
It confirms the diagnosis of pulmonary fibrosis.
Which laboratory finding is associated with Lymphangioleiomyomatosis (LAM)?
Serum VEGF-D testing
BRAF and MAP2K1 mutation
Anti-Ro (SS-A) and anti-La (SS-B) antibodies
Impaired gas exchange
What imaging feature is commonly seen in Pulmonary Langerhans cell histiocytosis (PLCH)?
Bronchiocentric nodules that cavitate
Regular distribution
Reticular opacity
GGO (Ground-glass opacities)
Which pathology is associated with mutations in the folliculin gene?
BHD (Birt–Hogg–Dubé syndrome)
LAM
PLCH
Amyloidosis
What is the first step in the imaging diagnostic algorithm in CLD according to the text?
Confirming whether or not it is a true cyst
Evaluating wall thickness
Assessing gas exchange
Testing for serum VEGF-D
Which of the following is NOT a typical laboratory finding for LCDD (Light chain deposition disease)?
Serum VEGF-D testing
Amorphous material stained with Congo red and birefringent at polarised light
Serum β-glucan levels
Serum LDH
Why should pulmonary cysts in people under 40 years or when numbering more than five be carefully investigated?
They may indicate a possible lung disease and require radiological follow-up
They are always benign and need no further investigation
They are only associated with ageing
They are always caused by infections
Which imaging feature is associated with Amyloidosis in the lungs?
Minimal fibrosis
Regular distribution
Bronchiocentric nodules
GGO (Ground-glass opacities)
What is the significance of evaluating wall thickness, size, number, shape, and distribution on chest HRCT examination in CLD?
It helps in the assessment and diagnosis of pulmonary cysts and related diseases
It is only useful for identifying infections
It is not necessary if the patient is under 40 years old
It is only used to confirm the presence of tumors
Which pathology is associated with B-cell clonal proliferation and diffuse localisation on imaging?
Amyloidosis
LAM
PLCH
PJP
What does the HRCT image in Figure 9(a) demonstrate in a patient with NF type 1?
Multifocal thin-walled lung cysts, bronchiectasis, and peribronchiolar thickening
Single large cyst with no other abnormalities
Diffuse ground-glass opacities only
Normal lung parenchyma
Which imaging technique is described as essential for the evaluation of chronic lung diseases (CLDs) due to its ability to differentiate between various disorders?
MRI
Ultrasound
High-Resolution Computed Tomography (HRCT)
X-ray
What was the confirmed diagnosis for the cystic lesion with a thick GGO halo shown in Figure 10 after surgery?
Lung adenocarcinoma
Tuberculosis
Pulmonary fibrosis
Sarcoidosis
According to the conclusions, why is HRCT considered important in the management of chronic lung diseases?
It is less expensive than other imaging methods.
It can be performed without any patient preparation.
It provides essential imaging for differentiating multiple entities with different pathological processes.
It is the only imaging method available for lung diseases.
In the context of the document, what should be considered if a diagnosis is not made after looking for ancillary findings in the thoracic or abdominal region?
Repeat the same imaging test
Consider systemic causes and evaluate the lungs again
Ignore the findings and discharge the patient
Prescribe antibiotics immediately
Which of the following is NOT listed as a contribution by Lassandro Francesco in the "Author contribution" section?
Guarantor of integrity of the entire study
Study concepts and design
Literature research
Clinical studies
What is the significance of optimal management of patients with chronic lung diseases, as mentioned in the document?
It eliminates the need for any imaging.
It requires a correct diagnosis through thorough analysis of findings, potentially avoiding the need for a lung biopsy.
It always requires surgical intervention.
It is only necessary for elderly patients.
Based on Figure 11, what changes are observed in the lungs of a COVID-19 pneumonia patient over three weeks?
The GGO areas disappear completely.
Two small cystic cavities with thickened walls and irregular shape appear.
The lungs return to normal.
The patient develops lung cancer.
Which disease is discussed in the article by Jawad H, Walker CM, Wu CC, et al. as recognizing the common and uncommon entities?
Cystic interstitial lung diseases
Pulmonary tuberculosis
Chronic obstructive pulmonary disease
Asthma
According to Dalpiaz G, Cancellieri A, what is the title of their book on diffuse lung diseases?
Atlas of diffuse lung diseases: a multidisciplinary approach
Pulmonary Pathology: A Practical Guide
Radiology of Chest Diseases
Comprehensive Thoracic Imaging
Which syndrome is associated with pulmonary cysts as described by Tobino K, Gunji Y, Kurihara M, et al.?
Birt–Hogg–Dubé syndrome
Marfan syndrome
Ehlers-Danlos syndrome
Goodpasture syndrome
What is the main focus of the study by Kanne JP, Yandow DR, Meyer CA regarding pneumocystis jiroveci pneumonia?
High-resolution CT findings in patients without HIV infection
Treatment protocols for HIV-positive patients
Epidemiology of pneumocystis jiroveci pneumonia
Histological analysis of lung tissue
Which publication discusses the radiological characteristics of pulmonary hydatid cysts?
Radiological characteristics of pulmonary hydatid cysts by Emilik D, Ödev K, Poyraz N, et al.
Atlas of diffuse lung diseases by Dalpiaz G, Cancellieri A
Pneumocystis jiroveci pneumonia by Kanne JP, Yandow DR, Meyer CA
Bronchogenic Cyst by Sarper A, Ayten A, Golbasi I, et al.
Based on the references, which disease is associated with cystic airspaces and is discussed as a feature of lung cancers?
Lung cancers
Asthma
Tuberculosis
Sarcoidosis
What is the main subject of the review by Salehi S, Abedi A, Balakrishnan S, et al.?
Imaging findings in COVID-19 patients
Diagnosis of lung cancer
Treatment of pulmonary fibrosis
Pathogenesis of cystic lung diseases
