{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:29:10Z","timestamp":1787232550935,"version":"build-2736575974"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":68,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the Medical Research Project Fund of Wuhan Municipal Health Commission","award":["WX23Q32"],"award-info":[{"award-number":["WX23Q32"]}]},{"name":"the Science and Technology Health Project of the Health Commission of Hubei Province","award":["WJ2025M013"],"award-info":[{"award-number":["WJ2025M013"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pulmonary tuberculosis typically exhibits characteristic imaging findings; however, radiological manifestations can be atypical in certain cases, leading to potential misdiagnosis based solely on CT imaging. We describe a 59-year-old man who developed a 4-month history of cough and a 2-week fever during postoperative radiotherapy following esophagectomy for esophageal cancer. CT scans revealed multiple, scattered cystic cavities in both lungs, characterized by regular shape and well-defined borders. Following anti-tuberculosis therapy, the pre-existing cystic cavities collapsed and evolved into nodular opacities, a change highly suggestive of cystic metastases given the patient\u2019s history of esophageal cancer. A biopsy confirmed granulomatous inflammation, and follow-up at eight months after the initiation of anti-tuberculosis therapy showed near-complete resolution of the lesions. Although cystic pulmonary tuberculosis is rarely reported, this case is notable for its distinct cystic characteristics. To our knowledge, this is the first case to systematically document the transformation of cystic lesions into nodules during anti-tuberculosis therapy\u2014a finding that may raise suspicion for cystic metastases and highlights the diverse and atypical radiological manifestations of tuberculosis in immunocompromised hosts.<\/jats:p>","DOI":"10.1186\/s12879-026-13809-2","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T09:55:19Z","timestamp":1781344519000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary tuberculosis mimicking cystic metastases: evolution from multiple cystic cavities to nodules during therapy"],"prefix":"10.1186","volume":"26","author":[{"given":"Chengqing","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlin","family":"Mei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shufang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhui","family":"Mei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Quan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"issue":"2","key":"13809_CR1","doi-asserted-by":"publisher","first-page":"529","DOI":"10.1016\/j.chest.2024.08.008","volume":"167","author":"AN Franciosi","year":"2025","unstructured":"Franciosi AN, Gupta N, Murphy DJ, Wikenheiser-Brokamp KA, McCarthy C. Diffuse Cystic Lung Disease: A Clinical Guide to Recognition and Management. Chest. 2025;167(2):529\u201347.","journal-title":"Chest"},{"issue":"1","key":"13809_CR2","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1186\/s13023-020-01448-y","volume":"15","author":"W Xu","year":"2020","unstructured":"Xu W, Xu Z, Liu Y, Zhan Y, Sui X, Feng R, Peng M, Li X, Wang J, Meng S, et al. Characterization of CT scans of patients with Birt-Hogg-Dub\u00e9 syndrome compared with those of Chinese patients with non-BHD diffuse cyst lung diseases. Orphanet J Rare Dis. 2020;15(1):176.","journal-title":"Orphanet J Rare Dis"},{"issue":"3","key":"13809_CR3","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1016\/j.resinv.2022.01.001","volume":"60","author":"A Jonas","year":"2022","unstructured":"Jonas A, Muelly M, Gupta N, Reicher JJ. Machine learning to distinguish lymphangioleiomyomatosis from other diffuse cystic lung diseases. Respir Investig. 2022;60(3):430\u20133.","journal-title":"Respir Investig"},{"issue":"7","key":"13809_CR4","doi-asserted-by":"publisher","first-page":"e548541","DOI":"10.1016\/j.crad.2021.02.015","volume":"76","author":"A Arango-D\u00edaz","year":"2021","unstructured":"Arango-D\u00edaz A, Mart\u00ednez-de-Alegr\u00eda-Alonso A, Baleato-Gonz\u00e1lez S, Garc\u00eda-Figueiras R, Ecenarro-Montiel A, Trujillo-Ariza MV, Lama-L\u00f3pez A. CT findings of pulmonary cysts. Clin Radiol. 2021;76(7):e548541\u2013548512.","journal-title":"Clin Radiol"},{"issue":"4","key":"13809_CR5","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.ccm.2025.07.010","volume":"46","author":"M Baqir","year":"2025","unstructured":"Baqir M, Moua T, Ryu JH. Amyloid and Light Chain Deposition Disorders. Clin Chest Med. 2025;46(4):711\u201325.","journal-title":"Clin Chest Med"},{"issue":"1","key":"13809_CR6","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1148\/radiol.2021200026","volume":"300","author":"SWY Yip","year":"2021","unstructured":"Yip SWY, Lam SHY, Lo CS, Wong HYF, Tai WM. Case 291: Amyloid-associated Cystic Lung Disease and Coexistent Mucosa-associated Lymphoid Tissue Lymphoma. Radiology. 2021;300(1):237\u201342.","journal-title":"Radiology"},{"issue":"10","key":"13809_CR7","doi-asserted-by":"publisher","first-page":"1907","DOI":"10.1007\/s00247-021-05035-6","volume":"51","author":"M Scolnik","year":"2021","unstructured":"Scolnik M, Glozman L, Bar-Yoseph R, Gur M, Toukan Y, Bentur L, Ilivitzki A. Atypical pulmonary metastases in children: the spectrum of radiologic findings. Pediatr Radiol. 2021;51(10):1907\u201316.","journal-title":"Pediatr Radiol"},{"issue":"4","key":"13809_CR8","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1016\/j.jiph.2023.02.013","volume":"16","author":"L Wang","year":"2023","unstructured":"Wang L, Liu J, Yang H, Peng L. Diffuse cystic lung disease caused by tuberculosis infection: Case series. J Infect Public Health. 2023;16(4):526\u201330.","journal-title":"J Infect Public Health"},{"issue":"3","key":"13809_CR9","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1016\/j.ijtb.2019.11.016","volume":"67","author":"R Kodati","year":"2020","unstructured":"Kodati R, Tadepalli A, Reddy C. Pulmonary tuberculosis presenting as diffuse cystic lung disease: An atypical manifestation. Indian J Tuberc. 2020;67(3):397\u20139.","journal-title":"Indian J Tuberc"},{"key":"13809_CR10","doi-asserted-by":"publisher","first-page":"100494","DOI":"10.1016\/j.jctube.2024.100494","volume":"37","author":"H Churako","year":"2024","unstructured":"Churako H, Tesema M, Tema L, Ababiya T, Wodajo D, Hadaro T, Tateso A, Anjajo E, Sidamo T, Bekele A. Pulmonary tuberculosis related diffuse cystic lung disease with recurrent pneumothorax mimicking pulmonary lymphangioleomyomatosis in Ethiopia: A review and case report. J Clin Tuberc Other Mycobact Dis. 2024;37:100494.","journal-title":"J Clin Tuberc Other Mycobact Dis"},{"issue":"4","key":"13809_CR11","doi-asserted-by":"publisher","first-page":"e20240173","DOI":"10.36416\/1806-3756\/e20240173","volume":"50","author":"E Marchiori","year":"2024","unstructured":"Marchiori E, Hochhegger B, Zanetti G. Multiple cystic\/cavitated metastases. J Bras Pneumol. 2024;50(4):e20240173.","journal-title":"J Bras Pneumol"},{"key":"13809_CR12","doi-asserted-by":"publisher","first-page":"105662","DOI":"10.1016\/j.ijscr.2021.105662","volume":"80","author":"T Tsuji","year":"2021","unstructured":"Tsuji T, Nishimura A, Tawara H, Kadoya S, Bando H, Tsunezuka Y. Unusual case of cavitary lung metastasis of esophageal cancer: A case report. Int J Surg Case Rep. 2021;80:105662.","journal-title":"Int J Surg Case Rep"},{"issue":"2","key":"13809_CR13","first-page":"e103730","volume":"18","author":"N Tiresse","year":"2026","unstructured":"Tiresse N, Boucaid A, Laamim R, Chafi K, Souhi H. Diffuse Bilateral Pseudo-Cystic Pulmonary Lesions Revealing Metastatic Lung Adenocarcinoma: A Case Report and Literature Review. Cureus. 2026;18(2):e103730.","journal-title":"Cureus"},{"issue":"8","key":"13809_CR14","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1046\/j.1440-1827.2000.01086.x","volume":"50","author":"T Takemura","year":"2000","unstructured":"Takemura T, Akiyama O, Yanagawa T, Ikushima S, Ando T, Oritsu M. Pulmonary tuberculosis with unusual cystic change in an immunocompromised host. Pathol Int. 2000;50(8):672\u20137.","journal-title":"Pathol Int"},{"issue":"5","key":"13809_CR15","doi-asserted-by":"publisher","first-page":"rjae365","DOI":"10.1093\/jscr\/rjae365","volume":"2024","author":"T Suwa","year":"2024","unstructured":"Suwa T, Kawamoto N, Morita S, Hasegawa H, Zaitsu J, Misumi K. Pulmonary tuberculoma-induced cyst formation leading to repeated pneumothorax: a case report. J Surg Case Rep. 2024;2024(5):rjae365.","journal-title":"J Surg Case Rep"},{"issue":"1","key":"13809_CR16","doi-asserted-by":"publisher","first-page":"60","DOI":"10.3855\/jidc.9719","volume":"12","author":"L Chen","year":"2018","unstructured":"Chen L, Zhang J, Zhang H. A large pulmonary cavity replaced by a tuberculosis granuloma and healed during treatment of a patient with tuberculosis. J Infect Dev Ctries. 2018;12(1):60\u20132.","journal-title":"J Infect Dev Ctries"},{"issue":"1","key":"13809_CR17","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s13293-018-0203-9","volume":"9","author":"W Tan","year":"2018","unstructured":"Tan W, Soodeen-Lalloo AK, Chu Y, Xu W, Chen F, Zhang J, Sha W, Huang J, Yang G, Qin L, et al. Sex influences the association between haemostasis and the extent of lung lesions in tuberculosis. Biol Sex Differ. 2018;9(1):44.","journal-title":"Biol Sex Differ"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-026-13809-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-13809-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-026-13809-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:03:41Z","timestamp":1787231021000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12879-026-13809-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,13]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["13809"],"URL":"https:\/\/doi.org\/10.1186\/s12879-026-13809-2","relation":{},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,13]]},"assertion":[{"value":"14 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This case report was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of Wuhan Pulmonary Hospital (NO. 2025KJ062). Informed consent was obtained from the patient enrolled in this study.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent for personal or clinical details and any accompanying images was obtained from the patient for publication of this case report.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"1540"}}