Hereditary lung blebs won’t multiply and take over
DEAR DR. ROACH: I am an active 68-year-old man in good health. I am thin, but not very tall. I am 5 feet, 10 inches tall and weigh about 170 pounds.
In the past five years, I have had three recurrences of spontaneous pneumothorax (collapsed lung); the first happened when I was in my 20s. None was very serious, and they all reinflated without medical intervention. A CT scan showed that there were about a dozen blebs scattered around my lungs, with the densest concentration on the lower left side.
The pulmonary specialist said that I probably have had these blebs all my life, and they may be hereditary (two first cousins have had this, too). However, I still have some concerns: Will the blebs multiply and eventually destroy my lungs? — D.I.
ANSWER: Spontaneous pneumothorax is an unusual condition, and classically occurs in tall and thin young men. I agree with your pulmonary specialist that these are likely to have been there your whole life. They don’t multiply. Since you have never smoked, you are not at higher risk for development of lung disease such as COPD (chronic bronchitis and emphysema). Symptoms of a ruptured bleb (which is just a large cystic structure inside the lung) include sharp chest pain and shortness of breath. The lung can deflate, since the negative pressure created by the diaphragm and chest wall is communicated to the airway, and there is no longer a pressure gradient to expand the lungs. Normally, the lungs heal themselves, and there is no need for intervention.