Multiple nodules with vacuoles in both lungs refers to the description in the imaging examination, and the possible causes are lung infection, tuberculosis, bronchopulmonary carcinoma and so on. 1. Lung infection: when the lungs are infected by certain pathogenic bacteria, such as Aspergillus infection, imaging examination can show multiple scattered nodular shadows in both lungs, and translucent areas, i.e., vacuolated shadows, can be seen within the lung nodules close to the pleura. Patients may be accompanied by fever, cough, chest tightness and other symptoms. 2. Tuberculosis: It is a special case of lung infection, caused by Mycobacterium tuberculosis. Imaging examination can see exudation, hyperplasia, vacuoles and other changes in both lungs, especially when nodules are accompanied by cavities, so we should be vigilant for cavitary tuberculosis. Patients may be accompanied by symptoms such as emaciation, fatigue, night sweating and so on. 3. Bronchopulmonary cancer: In some early stage lung cancers, due to the normal air-containing tissues in the tumor tissues which have not been replaced by cancer cells, small vacuoles can be seen in imaging examination, or due to the formation of fibrotic tissues caused by lung cancer, which leads to the rupture of alveolar walls, fusion, and small vacuoles can also be seen. Patients may be accompanied by symptoms such as chest tightness and hemoptysis. In addition to the above, multiple nodules with vacuoles in both lungs can also be caused by other diseases, such as tuberculosis, pneumoconiosis, hyperplastic granuloma, lymph node hyperplasia, etc. If you find multiple nodules with vacuoles in both lungs, you must consult a doctor in time, and the doctor will clarify the cause of the disease through further examination and carry out the corresponding treatment, so as to avoid delaying the condition.