Post-COVID-19 Vanishing Paraseptal Emphysema.

Abstract

HomeRadiologyVol. 299, No. 2 PreviousNext Reviews and CommentaryFree AccessImages In RadiologyPost–COVID-19 Vanishing Paraseptal EmphysemaEglantine Cabanne, Marie-Pierre Revel Eglantine Cabanne, Marie-Pierre Revel Author AffiliationsFrom the Service de Radiologie, Université de Paris, APHP Centre, Hôpital Cochin, 27 Rue du Faubourg Saint Jacques, 75014 Paris, France.Address correspondence to M.P.R. (e-mail: [email protected]).Eglantine CabanneMarie-Pierre Revel Published Online:Feb 23 2021https://doi.org/10.1148/radiol.2021210339MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack Citations ShareShare onFacebookTwitterLinked In A 77-year-old woman with a 40-pack-year smoking history was admitted to the intensive care unit with severe acute respiratory syndrome coronavirus 2 pneumonia and an oxygen saturation level of 88% on room air at presentation. She responded well to treatment with dexamethasone. The chest CT scan at admission showed bilateral peripheral ground-glass opacities predominating in the right middle lobe with marked paraseptal emphysema in the lower lobes (Figure, part a). Four months later, a chest CT scan showed that the paraseptal emphysematous changes had nearly resolved and had been replaced by a thin linear band of what may represent organizing pneumonia (Figure, part b).a: Images in 77-year-old woman with 40-pack-year smoking history who was admitted to intensive care unit with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia and oxygen saturation level of 88% on room air at presentation. (a) Chest CT scan at admission shows paraseptal emphysema in both lower lobes and ground-glass opacities related to SARS-CoV-2 infection predominating in subpleural areas of right middle lobe. (b) Chest CT scan 4 months later shows that ground-glass opacities have resolved and that paraseptal emphysematous changes posteriorly have almost completely resolved and have been replaced by thin linear band of what may represent organizing pneumonia (arrows).a:Download as PowerPointOpen in Image Viewer b: Images in 77-year-old woman with 40-pack-year smoking history who was admitted to intensive care unit with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia and oxygen saturation level of 88% on room air at presentation. (a) Chest CT scan at admission shows paraseptal emphysema in both lower lobes and ground-glass opacities related to SARS-CoV-2 infection predominating in subpleural areas of right middle lobe. (b) Chest CT scan 4 months later shows that ground-glass opacities have resolved and that paraseptal emphysematous changes posteriorly have almost completely resolved and have been replaced by thin linear band of what may represent organizing pneumonia (arrows).b:Download as PowerPointOpen in Image Viewer Resolution of large emphysematous bullae after infection has been previously reported and is referred to as an “autobullectomy” (1,2). The hypothesis for why this occurs is that the airway inflammation caused by the infection is associated with the closure of the communication between the airways and the bullae. In this scenario, perhaps the loss of the patient’s paraseptal emphysema is related to the healing phase of the viral pneumonia with loss of the airways communicating with these regions.Disclosures of Conflicts of Interest: E.C. disclosed no relevant relationships. M.P.R. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: received payment for educational lectures from MSD France; received reimbursement from Guerbet for travel and accommodations related to meeting expenses. Other relationships: disclosed no relevant relationships.