Bilateral Spontaneous Pneumothorax in a Young Gentleman
Albert Teng1, Tzy Harn Chua2, Chun Yuen Chow2
1Department of Respiratory and Critical Care Medicine Singapore General Hospital Singapore Singapore.
Respirology Case Reports
|October 1, 2025
Summary
Bilateral spontaneous pneumothorax in young smokers can indicate pulmonary Langerhans cell histiocytosis (PLCH). Early diagnosis and smoking cessation are crucial for managing this rare cystic lung disease.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Pathology
Background:
- Bilateral spontaneous pneumothorax is a rare condition, often associated with underlying lung disease.
- Young smokers presenting with pneumothorax warrant investigation for underlying cystic lung pathologies.
- Pulmonary Langerhans cell histiocytosis (PLCH) is an uncommon cystic lung disease.
Purpose of the Study:
- To report a case of bilateral spontaneous pneumothorax in a young smoker.
- To highlight the diagnostic challenges and features of PLCH.
- To emphasize the importance of prompt diagnosis and management.
Main Methods:
- Case report of a 26-year-old male with bilateral pneumothorax.
- Diagnostic workup included chest radiography, high-resolution computed tomography (HRCT), and surgical lung biopsy.
- Treatment involved bilateral chest tube insertion, video-assisted thoracoscopic surgery (VATS) with bullectomy, pleurodesis, and biopsy.
Main Results:
- Chest radiography confirmed bilateral pneumothoraces.
- HRCT revealed multiple bilateral thin-walled cysts with lung base sparing and peripheral nodules.
- Histopathology confirmed PLCH with Langerhans cells and eosinophilic infiltration.
Conclusions:
- Young smokers with spontaneous bilateral pneumothorax should be evaluated for PLCH.
- Radiologic and histopathologic findings are essential for diagnosing cystic lung diseases like PLCH.
- Smoking cessation is the primary management strategy for PLCH.
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