• Definitions
  1. Pulmonary Bleb
    1. Small (<1-2 cm), thin walled (<1 mm) air containing spaces within the lung
  2. Pulmonary Bullae
    1. Larger (>1-2 cm) air containing spaces within the lung
    2. A Pulmonary Bulla may be a coalescence of Pulmonary Blebs
  • Pathophysiology
  1. Blebs and Bullae form as a result of subpleural alveolar rupture
  • Risk Factors
  1. Tobacco Abuse
  2. Thin Patient
  3. COPD
  • Differential Diagnosis
  1. Pneumatocele (post-Pneumonia)
  2. Pneumothorax
  3. Cystic Bronchiectasis
  4. Cavitary Lung Disease
  5. Cystic Lung Disease
    1. Lymphangioleiomyomatosis (LAM)
    2. Pulmonary Langerhans Cell Histiocytosis (PLCH)
    3. Birt-Hogg-Dube Syndrome (BHD)
    4. Lymphoid Interstitial Pneumonia (LIP)
  • Complications
  1. Pneumothorax
  2. Bullae secondary infection
  3. Giant Bullous Emphysema (Vanishing Lung Syndrome)
    1. Large bullae, in some cases filling the entire hemithorax
    2. May impair lung function
  • Resources
  1. Lung Bleb (Radiopaedia)
    1. https://radiopaedia.org/articles/pulmonary-bleb?lang=us
  • References
  1. Kumar and Kotloff (2018) Diagnostic Approach to the Adult with Cystic Lung Disease, UpToDate, accessed 8/5/2019
  2. Collins and Stern (2008) Chest Radiology, Wolters Kluwer, Philadelphia, p. 234-5