Presentation
Acute shortness of breath.
Patient Data
Large bulla in the left posterior upper lung. There is a similar bulla seen in the right upper lung. Partial atelectasis of the lower lung parenchyma bilaterally and architectural distortion. Costophrenic angles are clear, and cardiac size is normal.
Extensive severe bullous emphysema in both lungs. There is a nodular density in the right upper lobe with adjacent stranding that is stable from previous imaging. Enlarged 11 mm subcarinal lymph node which is also stable from previous imaging. No other significant intrathoracic abnormality is present.
Case Discussion
Chronic inflammation of distal airspaces results in a breakdown of alveolar walls which leads to enlargement of airspaces resulting in bullae formation. Complications of bullous emphysema can include spontaneous, traumatic or tension pneumothorax.
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