Unusual etiology of cystic lesions in the lung.

57 year old man was admitted because of cystic lesions on his chest x-ray film (Fig 1). Eight months earlier, transitional cell carcinoma of the bladder, grade 3, was diagnosed, for which he received local irradiation, followed by radical cystectomy. There was no evidence of metastatic disease. On admission, the patient denied increased cough, sputum production, dyspnea, fever, weight loss, hemoptysis, or exposure to tuberculosis. The findings from his pulmonary examination were normal. A test with intermediatestrength purified protein derivative of tuberculin (PPD) was nonreactive, and fungal serologic studies were negative. A transthoracic needle aspiration was performed.