Kosin Med J.  2018 Dec;33(3):409-414. 10.7180/kmj.2018.33.3.409.

Complete resolution of the giant pulmonary bulla: a case of inflammatory autobullectomy

• Park S
• Shi H
• Wang S
• Lee S
• Ko Y
• Park YB

• KMID: 2442553
• DOI: http://doi.org/10.7180/kmj.2018.33.3.409

Abstract

Giant pulmonary bulla (GPB) is a rare manifestation of emphysema and usually enlarges gradually over time, occasionally resulting in complications. Hence, more often than not, the surgical intervention of a Bullectomy is the standard method of treatment for GPB. However, there are case reports that show the complete resolution of GPB after its inflammation process even without surgical intervention. A 51-year-old man was admitted to our clinic due to pleuritic pain. After a chest X-ray and CT scan, a new air-fluid level within the GPB was revealed in the right upper lobe of his lung. His clinical status had improved promptly with intravenous antibiotics. A one-year follow-up study showed the GPB was completely resolved.

Keyword

Giant pulmonary bulla; Inflammatory autobullectomy; Medical treatment of pulmonary bulla

MeSH Terms

Anti-Bacterial Agents
Emphysema
Follow-Up Studies
Humans
Inflammation
Lung
Methods
Middle Aged
Thorax
Tomography, X-Ray Computed
Anti-Bacterial Agents

Figure

• 

  Fig. 1 Serial chest radiography shows spontaneous resolution of the GPB in the right upper lobe. (A) 4 years ago of episode, chest radiography shows GPB in the right upper lobe; (B) At admission, chest radiography shows the air-fluid level within the GPB; (C) 3 weeks after episode, chest radiography still shows the air-fluid level within the GPB but the GPB diminished in size; (D) 12 months after episode, chest radiography shows complete disappearance of the GPB.

• 

  Fig. 2 Chest computed tomography shows the GPB with air-fluid level (arrowhead) in the right upper lobe.

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  Fig. 3 Improvement of lung function after inflammatory autobullectomy.

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