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04:44
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Persistent diffuse pulmonary interstitial emphysema mimicking pulmonary emphysema
Y Demura1, T Ishizaki, M Nakanishi
1Department of Respiratory Medicine, Faculty of Medical Sciences, University of Fukui Hospital, Fukui, Japan.
BMJ Case Reports
|June 21, 2011
Summary
Pulmonary interstitial emphysema, not COPD, was diagnosed in an asthma patient. Treatment improved symptoms, but CT findings of free air persisted, suggesting a link to severe asthma exacerbations.
Area of Science:
- Pulmonology
- Radiology
- Internal Medicine
Background:
- A 69-year-old male with atopic asthma presented with symptoms mimicking chronic obstructive pulmonary disease (COPD).
- Initial lung function tests and chest radiography supported a COPD diagnosis.
- However, chest CT revealed pulmonary interstitial emphysema, not COPD-related emphysema.
Purpose of the Study:
- To investigate the cause of respiratory symptoms in an asthma patient initially suspected of having COPD.
- To characterize the CT findings of pulmonary interstitial emphysema in this patient.
- To assess the relationship between asthma exacerbations and the development of pulmonary interstitial emphysema.
Main Methods:
- Clinical presentation and history of atopic asthma.
- Pulmonary function testing.
- Chest radiography and computed tomography (CT) scan.
- Response to treatment for airways disease.
Main Results:
- Chest CT demonstrated free air along bronchovascular sheaths, indicative of pulmonary interstitial emphysema.
- This finding was attributed to potential repeated exacerbations of asthma.
- Lung function tests and symptoms improved with asthma treatment, but CT findings remained unchanged after two years.
Conclusions:
- Pulmonary interstitial emphysema can occur in patients with severe atopic asthma, potentially secondary to exacerbations.
- CT imaging is crucial for differentiating pulmonary interstitial emphysema from COPD in such cases.
- Persistent CT findings despite clinical improvement highlight the chronic nature of this condition.
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