Hered­i­tary lung blebs won’t mul­ti­ply and take over

Ripon Bulletin - - Local/state - Keith Roach, M.D.

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.

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