Chest radiographs and CT scan may reveal an opacity or a lucent, cystic, fluid-filled mass resembling an abscess in the pulmonary zone affected, and high-resolution CT scanning is proposed as a reliable paraclinical investigative procedure that allows more accurate assessment for the site and extent of CCAM. Radiographic analysis may preoperatively suggest the diagnosis, especially when a multicystic pattern like our present case is evident. When the cystic lesion is single, the differential diagnosis with the congenital parenchymal cysts and other cystic lesions is not possible only on the basis of the radiologic features. In particular, in the case of wall thickness >4 mm, the differential diagnosis should include various etiologies: neoplastic origin (bronchogenic carcinoma, metastases, lymphoma), infections by bacteria (Staphylococcus aureus, gram-negative bacteria, Mycobacterium, actinomycosis, and nocardiosis), fungi (aspergillosis, mucormycosis, and cryptococcosis) and/or parasites, immunologic diseases (Wegener granulomatosis), pulmonary embolism, pneumoconiosis, localized bronchiectasis, CCAM, and pulmonary sequestration.17 The multicystic lesion with thick walls and solid content observed in our present case is more often seen in pulmonary sequestration, in infectious causes, and in necrotic cancer. In fact, it can be easy for CCAM to be confused with lung infections on radiographic examination. Moreover, small CCAM lesions may not be visible on chest radiographs.1 Therefore, using more advanced modalities, differential diagnosis has to be done from other rare cystic tumors, and the effort to find the small lesions is required.13 Specifically, in light of an association with pulmonary sequestration, the contrast-enhanced CT scan or CT scan angiogram is noteworthy for the distinction between CCAM and sequestration, since the absence of aberrant vessels to the cystic lesion is a key feature of CCAM. In all the series reported, CCAM occurs with equal frequency in the right and left lung, usually confined to one lobe, and there is a predilection for occurrence in the posterior basal segments of the lower lobes.12 The cases of multilobular disease are much less frequent, and thus the cases of bilateral diseases are rarer.1 Interestingly, our current patient had CCAM in both lobes, the posterior basal segments of the lower lobes, with a communicating bridge. It did not communicate any tracheobronchial tree or pleural space. The radiologic feature of the bridge between the two cystic lesions was similar to fibrotic septum in the lesions themselves. Supporting this radiologic finding, histologic examination showed that the bridge was composed of fibrotic connective tissues. Therefore, we hypothesized that this communicating bridge may be formed as the result of repetitive inflammation in the cystic lesions.