Regression of lung bullae after pulmonary infection: Two case reports and the aspect of radiologic and pathologic findings in one case

Abstract

A sharply demarcated area of emphysema, bleb or bulla, is usually asymptomatic. Some could lead to pneumothorax or superimposed infection, the common complications, while some could be spontaneously resolved, of which mechanism remains unclear. We present two male patients who had asymptomatic bullae at their right upper lungs. The first patient presented with a low-grade fever for a month. His chest radiograph showed a new patchy opacity in right upper lung, which corresponds to an enhancing mass with central necrosis on the chest computed tomography. His tissue pathology from two specimens of pleura had proven as inflammation and fibrosis. After antibiotics treatment, the follow-up images showed partial regression of the bullae. Another patient presented with right pleuritic chest pain for 16 days and was diagnosed as pneumonia with an infected lung bulla. His chest radiograph showed a newly seen patchy opacity at the right middle lung zone and a new air-fluid level in the lung bulla in the right upper lobe. After he had been given antibiotics treatment, partial regression of the bulla was observed. He later underwent right upper lobectomy and successful smoking cessation. The follow-up chest images showed no new bleb or bulla.