The underlying cause of the destroyed lung is changing: a clinico-radiological study

Abstract Background A destroyed lung (DL) is the complete destruction of the lung due to chronic infections, particularly tuberculosis (TB). To diagnose DL, one must demonstrate radiologically significant damage to the lung, in addition to clinical features. This study aims to describe the clinical and radiologic characteristics of DL. Methods The study reviewed thorax CT results from January 2014 to October 2023. For a comparative analysis, we divided the patients into three groups: patients with cystic fibrosis (CF), those with TB, and those with severe pneumonia (SP). CT scans were examined for bronchiectasis, cavitation, herniation, etc. Results We identified 32 DL patients from 3355 CT reports. The main underlying causes of DL were TB (31.3%), CF (25.0%), and SP (46.9%). There was a predominance of left lung (65.6%). On the affected side, the main findings were bronchiectasis (90.6%), a decrease in the diameter of pulmonary vessels (87.5%), and cavitation (53.1%), while the contralateral side showed bronchial wall thickening (81.3%), bronchiectasis (71.9%), and air trapping (71.9%). CF patients were younger than the other groups (median age 27.0 years; p = 0.004) and more frequently received long-term oxygen therapy ( p = 0.013). Patients with CF had more mucous plugging than others ( p = 0.013), whereas none of the patients with CF had emphysema ( p = 0.013). Conclusion In recent years, CF, along with TB and SP, has become one of the major causes of DL. Recognizing the differences in clinical and radiologic results based on the underlying cause is crucial for patient management. Clinical trial number Not applicable.