• Nishant Gupta, Thomas V Colby, Cristopher A Meyer, Francis X McCormack, and Kathryn A Wikenheiser-Brokamp.
• Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati, Cincinnati, OH; Medical Service, Veterans Affairs Medical Center, Cincinnati, OH. Electronic address: guptans@ucmail.uc.edu.
• Chest. 2018 Aug 1; 154 (2): e31-e35.

AbstractExposure to cigarette smoke can lead to a variety of parenchymal lung diseases, including diffuse cystic lung diseases (DCLDs). Lymphangioleiomyomatosis (LAM) is the prototypical DCLD and has a characteristic appearance on high-resolution CT (HRCT). We present a series of four patients with DCLD on HRCT who were referred to our institution with a presumed diagnosis of LAM and who were found instead to have smoking-related injury of the small airways on histopathological analysis. We submit that cigarette smoke-induced small airway injury can present as DCLD on HRCT in a pattern that can mimic LAM. A detailed history of cigarette smoke exposure should be obtained in patients presenting with DCLD, and imaging features should not be used in isolation to establish a firm diagnosis of LAM.Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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