Spontaneous Partial Resolution of a Giant Pulmonary Bulla

Case Report

Austin J Pulm Respir Med 2014;1(4): 1017.

Spontaneous Partial Resolution of a Giant Pulmonary Bulla

Ryland P Byrd Jr* and Thomas M Roy

Pulmonary and Critical Care Medicine Division, East Tennessee State University, USA

*Corresponding author: Ryland P Byrd Jr, Pulmonary and Critical Care Medicine Division, Quillen College of Medicine, East Tennessee State University, Veterans Affairs Medical Center 111-B, PO. Box. 4000, Mountain Home, TN 37684-4000, USA

Received: February 06, 2014; Accepted: July 31, 2014; Published: Aug 08, 2014


Spontaneous partial resolution of giant pulmonary bullae occurs infrequently. The pathophysiology responsible for the natural elimination of giant bullae is not known with certainty. We report a patient who experienced spontaneous sub-total regression of his giant bulla following an infection. This observation suggests that airway inflammation and obstruction may play a role in the mechanism for spontaneous resolution and/or regression of giant bullae.

Keywords: Giant bulla; Spontaneous resolution; Pulmonary


Bullous emphysema is a common consequence of the inhalation of combusted tobacco products. Multiple small bullae typically develop as a consequence of smoking tobacco products. The development of giant bullae is uncommon. Giant bullae typically progressively enlarge and, over time, cause compressive atelectasis of the adjacent pulmonary parenchyma [1,2]. Patients may experience increasing respiratory compromise as the giant bullae increase in size. Giant bullae rarely resolve spontaneously. Eleven cases of complete resolution and six cases with partial regression of giant bullae are recorded in the English literature [3-15]. We report a patient who experienced a sub-total resolution of a giant bulla following an infectious episode.

Case Presentation

A 60 year-old male was referred for evaluation of abnormal computerized tomogram scanning (CT) of the chest. A CT two years earlier demonstrated a giant bulla in his left upper lobe (Figure 1).