CTICasesLupus with Cystic Lung Destruction (mimicking honeycombing)
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Imaging findings
This case shows large areas of cystic replacement, especially in the lower lobes, without the thick walls or peripheral distribution typical of simple honeycombing. Most visualized lung portions are completely replaced by these coalescent, mottled, but not extremely thick-walled cysts. There are some areas of distortion and possible honeycombing that appear anterior and sharply demarcated. Vessels and bronchi appear relatively normal, without significant traction bronchiectasis.
Key takeaways
Lupus can present with atypical cystic lung destruction that mimics honeycombing but is pathologically distinct, often representing complete lung destruction rather than classic UIP-pattern honeycombing. The appearance may overlap with Lymphoid Interstitial Pneumonia (LIP). Key clues include the extensive, confluent cystic appearance, lack of significant traction bronchiectasis, and preserved airways.
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