Pediatric Pneumatocele

  • Etiology: Transient collection of interstitial air due to infection and necrotic bronchi in Staphylococcus pneumonia, blunt thoracic trauma, positive pressure ventilation, hydrocarbon ingestion
  • Imaging:
    — Thin wall
    — Usually no air-fluid level in infectious cases
    — Occurs later in course of infection
  • DDX: Abscess
    — Abscess appears earlier in infection, has thick irregular walls, lasts long time
    — Pneumatocoele occurs later in infection, has thin wall, usually no air fluid level
  • Complications:
  • Treatment:
  • Clinical:

Radiology Cases of Pneumatocele

Radiology Cases of Post Infectious Pneumatocele

CXR of pneumatocele
CXR shows a large thin walled cystic lesion in the left lower lobe.
CXR and CT of post-infectious pneumatocele
CXR AP (above left) initially shows an infiltrate in the left lower lobe that on a CXR AP one week later (above right) has developed a cystic cavity in the middle of it. A left pleural effusion is also now present. Axial CT with contrast of the chest (below) shows the cystic cavity is thin walled and septated. Left lower lobe consolidation and left pleural effusion remain present.
CXR and CT of post-infectious pneumatocele
CXR AP (above) shows the arterial catheter tip projecting over the aortic arch and the venous catheter tip projecting over the right atrium. There is bilateral diffuse airspace disease and bilateral pleural effusions. A cystic lesion is seen in the right lower lobe. Axial CT without contrast of the chest (below left) shows the cystic lesion is thin walled and communicates with the bronchial tree and has multiple septations (below right).

Radiology Cases of Post Traumatic Pneumatocele

CXR and CT of pneumatoceles
CXR AP shows patchy airspace disease in the right lung. Axial CT with contrast of the chest shows right-sided airspace disease as well as thin-walled cysts with fluid-fluid levels.

Radiology Cases of Positive Pressure Ventilation Pneumatocele

CXR and CT of pneumatocele
CXR (above) and axial CT without contrast of the chest (below) shows diffuse interstitial thickening and a large, round, unilocular thin-walled cyst in the posterobasal aspect of the right lower lobe. The bronchus of the posterobasal segment of the right lower lobe was seen to extend into it.