Medical image of the week: spontaneous pneumothorax in end stage fibrotic lung disease

• Main Authors: Altisheh R, Carr T
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2017-06-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: pneumothorax; spontaneous; fibrosis; lung; fibrotic lung disease; chest x-ray; CT scan; treatment; hypersensitivity pneumonitis; symptoms
• Online Access: http://www.swjpcc.com/imaging/2017/6/14/medical-image-of-the-week-spontaneous-pneumothorax-in-end-st.html

No abstract available. Article truncated after 150 words. A 61-year-old nonsmoking man with chronic obstructive lung disease, pulmonary hypertension, pulmonary fibrosis, hypertension, coronary artery disease with congestive heart failure, presented with recurrent pneumothorax, pneumomediastinum, extensive subcutaneous emphysema and bronchopleural fistula. The patient reported ongoing symptoms of exertional dyspnea, fatigue, and coughing for years. His environmental exposures were notable for exposure to birds since early childhood. He had 6 cockatiels and 2 doves living inside his home and is directly responsible for their care. Former occupational exposures include painting and sandblasting. Family history was notable for early onset non specified lung disease in his father, and rheumatoid arthritis in his mother. Lung function testing performed prior to the bronchopleural fistula revealed moderate obstructive ventilatory defect with severely limited DLCO. Chest x-ray (Figure 1) revealed a moderate-sized right pneumothorax with a pigtail chest tube in place and diffuse reticular interstitial opacities. His CT chest (figure 2) revealed extensive subcutaneous emphysema …