© 2002 The Fellowship of Postgraduate Medicine
SELF ASSESSMENT QUESTION
Respiratory medicine
Bullous lungs: diverse aetiology
Department of Respiratory Medicine, T N Medical College and BYL Nair Hospital, Mumbai 400008, India
Correspondence to:
Correspondence to:
Professor Joshi;
drjoshijm@email.com
Accepted 22 July 2002
Answers on p 692
| The first 150 words of the full text of this article appear below. |
A 26 year man, a non-addict, was referred to us as he had a right sided spontaneous pneumothorax. His past medical history included surgery done at the age of 12 years for bilateral inguinal hernia and aphakia of both eyes. On physical examination there was elasticity of skin over the abdomen. Cardiac examination revealed a systolic murmur over the apex.
Routine blood tests were within normal limits. Chest radiography revealed a right sided pneumothorax, which was treated with intercostal tube drainage after which his lung expanded completely. The underlying lungs revealed the presence of bilateral bullous change (fig 1
); this was confirmed on high resolution computed tomography (HRCT), which showed extensive bilateral bullous disease, especially marked in left where bullae virtually replaced the lung parenchyma (fig 2). His 
1-antitrypsin levels were 199 IU/l (normal 93–224). Spirometry showed obstructive airway disease with poor bronchodilator reversibility, and increased
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Bullous lungs: diverse aetiology
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