Severe bullous emphysema: exploring risk factors and the importance of radiography

Bullous emphysema, a subtype of emphysema, is characterized by the irreversible enlargement of air-filled airways greater than 1cm in size. Often time, practitioners focus on smoking duration in pack years, and smoking frequency, rather than smoking onset, when assessing risk for development of bullous emphysema. Distinct radiographic findings on CT imaging can differentiate bullae from other lung pathologies, including lung cysts. Here, we present a young female with diffuse, bullous emphysema without an extensive smoking history. We aim to highlight the importance of smoking onset when determining risk for development bullous emphysema, as well as the role of CT imaging in the diagnosis of lung pathologies.