Spontaneous regression of the lung bulla

Abstract

     Blebs and bullae are gas-containing spaces commonly found in many conditions and usually cause no symptoms, but may progress over time resulting in respiratory distress; pneumothorax and superimpose infections are common complications of bullae. Spontaneous regression of the bulla is rarely encountered, and its mechanism remains unclear. However, a few case reports suggest that it usually occurs after an infection or a rupture.

We present a 72-year-old male ex-smoker who presented with progressive dyspnea for 1 month. His chest radiograph showed a few lung blebs and bullae in the right upper to middle lung field. Bronchodilators and anti-inflammatory medications were prescribed and he was referred to the pulmonologist. His first chest CT also showed multiple blebs and a large bulla in the bilateral upper lobes and he was scheduled for bullectomy because his bullae were symptomatic. However, at a 17-month follow up, his symptoms spontaneously improved and his chest CT showed regression of the bulla with only a few small calcifications and pleural thickening in the right upper lobe remaining.