Volume 135, Issue 5, Pages 1389-1394 (May 2009) A 47-Year-Old Woman With Progressive Dyspnea and Recurrent Pneumothoraces  Seth Brant, MD, Mark S. Parker, MD, Lisa K. Brath, MD, FCCP, Margaret M. Grimes, MD, FCCP  CHEST  Volume 135, Issue 5, Pages 1389-1394 (May 2009) DOI: 10.1378/chest.08-1168 Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 1 Radiologic findings and legends. Posteroanterior (left, A) and lateral (right, B) chest radiographs demonstrate increased lung volumes and diffuse bilateral reticular opacities. Subtle cystic airspaces are seen to better advantage on the lateral examination. A small left apical pneumothorax and an ipsilateral area of linear scarring in the upper lobe are also seen. CHEST 2009 135, 1389-1394DOI: (10.1378/chest.08-1168) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 2 HRCT scan. A selected image at the carina reveals the presence of diffuse thin-walled cysts ranging between 0.2 and 2.0 cm in size throughout both lungs. The upper and lower lungs were equally affected. The apical pneumothorax is out of the field of view. A few indeterminate subcentimeter nodules were seen elsewhere in the chest (not illustrated). CHEST 2009 135, 1389-1394DOI: (10.1378/chest.08-1168) Copyright © 2009 The American College of Chest Physicians Terms and Conditions

Figure 3 Walls of the cystic parenchymal lesions consist of alveolar septa infiltrated by spindle and epithelioid cells (hematoxylin-eosin, original × 40). CHEST 2009 135, 1389-1394DOI: (10.1378/chest.08-1168) Copyright © 2009 The American College of Chest Physicians Terms and Conditions