Vanishing Lung Syndrome
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Samer Al Hadidi
A 39-year-old man presented with a 1-year history of dyspnea on exertion and a single episode of hemoptysis. Medical history was also significant for 15-pack-per-year cigarette use and mild intermittent asthma. Physical examination revealed diffuse bilateral wheezing and decreased air entry with hyperresonant percussion at the right lower lung. Laboratory results were normal. Chest radiograph (image A, arrow) demonstrated a giant right pulmonary bulla, supporting the diagnosis of vanishing lung syndrome. Partial right lung lobectomy was performed 8 months later, and a chest radiograph showed resolution of the bulla (image B, arrow).
Vanishing lung syndrome is a chronic progressive condition. It is defined as bullae occupying at least one-third of the hemithorax.1 Risk factors include tobacco use, male sex, α-1-antitrypsin deficiency, and marijuana use.2-3 Tension pneumothorax is a potentially life-threatening complication. Although bullectomy is the treatment of choice, indications for surgical intervention should be individually assessed.4


References
1. Sharma N , JustaniahAM, KanneJP, GurneyJW, MohammedTL. Vanishing lung syndrome (giant bullous emphysema): CT findings in 7 patients and a literature review. J Thorac Imaging. 2009;24(3):227-230. doi:10.1097/RTI.0b013e31819b9f2aSearch in Google Scholar
2. Hii SW , TamJD, ThompsonBR, NaughtonMT. Bullous lung disease due to marijuana. Respirology. 2008;13(1):122-127. doi:10.1111/j.1440-1843.2007.01186.xSearch in Google Scholar
3. Hutchison DC , CooperD; British Thoracic Society. Alpha-1-antitrypsin deficiency: smoking, decline in lung function and implications for therapeutic trials. Respir Med. 2002;96(11):872-880.10.1053/rmed.2002.1381Search in Google Scholar
4. Palla A , DesideriM, RossiG, et al. Elective surgery for giant bullous emphysema: a 5-year clinical and functional follow-up. Chest. 2005;128(4):2043-2050. doi:10.1378/chest.128.4.2043Search in Google Scholar
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Articles in the same Issue
- SURF
- Effects of Clinical Exposure to Osteopathic Manipulative Medicine on Confidence Levels of Medical Students
- EDITORIAL
- A Path to Osteopathic Distinction: The Touro California GROUPIE Program
- ORIGINAL CONTRIBUTION
- Fundamentals for an Osteopathic Obesity Designed Study: The Effects of Education on Osteopathic Medical Students’ Attitudes Regarding Obesity
- Clinical Preceptors’ Perceptions of Empathy: The Empathy in Osteopathic Training and Education (EMOTE) Study
- REVIEW
- Functional Somatic Syndrome: Assessment and Management
- Conversion of Sugar to Fat: Is Hepatic de Novo Lipogenesis Leading to Metabolic Syndrome and Associated Chronic Diseases?
- MEDICAL EDUCATION
- Ready for Residency: A Bloomian Analysis of Competency-Based Osteopathic Medical Education
- CASE REPORT
- Pheochromocytoma-Induced Cardiomyopathy Mimicking Acute Coronary Syndrome
- CLINICAL IMAGES
- Vanishing Lung Syndrome
- Obliterated Temporomandibular Joint