Diffuse cystic lung diseases - Tuberculosis has to be included in the differentials for Indian context !

Sir, I read with interest the review article “Diffuse cystic lung diseases: Imaging spectrum and diagnostic approach using high-resolution computed tomography” by Singh et al.[1] The diagnostic approach explained was very relevant and useful for clinicians during evaluation of such a patient. But I have the following points to offer: Tuberculosis can present as diffuse cystic lung disease.[2–4] Though such presentation is very rare, being a high tuberculous burden country, Indian algorithm for diffuse cystic lung disease would benefit from including the disease, as it is a potentially reversible cause of lung cysts.[4] Cystic lung diseases are prone to develop pneumothorax. A computed tomography (CT) during a pneumothorax would lead to missed parenchymal findings of the ipsilateral collapsed lobe/lung and those findings could be critical in clinching the diagnosis. So, patients with such diffuse cystic lung disease should have a repeated CT after the drainage of pneumothorax. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.