Bullous emphysema

Three photos of emphysematous bullae. Bullae can develop in the subpleural region in any type of emphysema. These large air-containing spaces can be very thin-walled. In paraseptal emphysema, involvement is most striking near the pleura, often leading to spontaneous pneumothorax in young persons when a bleb ruptures. Some regard the term bleb as synonymous with bulla but others limit the use of the term bullae to lesions larger than 1 cm in diameter.

Primary spontaneous pneumothorax occurs in persons with no underlying lung disease. Secondary spontaneous pneumothorax occurs in patients with chronic obstructive pulmonary disease and other diseases such as sarcoidosis, tuberculosis, pneumonia, cystic fibrosis, lung tumors, and interstitial lung diseases.

From the slide collection of the late Dr. Charles Kuhn