Differential Diagnosis for Loculated Pneumothorax
Single Most Likely Diagnosis
- Congenital Pulmonary Airway Malformation (CCAM): This condition is a developmental anomaly that can present with a loculated pneumothorax, especially in the neonatal period or early infancy. CCAMs can cause respiratory distress and may be associated with pneumothorax due to the abnormal lung tissue.
Other Likely Diagnoses
- Congenital Lobar Emphysema (CLE): Although CLE typically presents with hyperinflation of a lung lobe, it can occasionally cause a loculated pneumothorax, especially if there is a complication such as rupture of the emphysematous lobe.
- Pneumatoceles: These are air-filled cysts that can form in the lung parenchyma, often as a result of infection (like pneumonia) or trauma. They can mimic a loculated pneumothorax on imaging.
Do Not Miss Diagnoses
- Tension Pneumothorax: Although not typically "loculated," a tension pneumothorax is a life-threatening condition that requires immediate recognition and treatment. It can present with signs of severe respiratory distress and hemodynamic instability.
- Pulmonary Sequestration: This rare congenital anomaly involves a portion of lung tissue that receives its blood supply from an anomalous systemic artery. It can present with recurrent infections or pneumothorax, including loculated pneumothorax.
Rare Diagnoses
- Bronchogenic Cyst: These congenital anomalies are fluid-filled cysts that can become air-filled and mimic a loculated pneumothorax if they communicate with the airway.
- Pulmonary Lymphangioma: A rare congenital condition that can cause cystic changes in the lung and potentially mimic a loculated pneumothorax on imaging.