title: Regression of giant bullous emphysema.
abstract: Spontaneous resolution of bulla associated with infection or tumor is occasionally observed. However, resolution of progressively enlarging giant bullous emphysema (GBE) after medical therapy has not been reported. A 51-year-old man smoker with GBE on the right lung was referred to Samsung Medical Center for the consideration of bullectomy. A review of his medical records revealed that right-side bullous emphysema had been detected 4 years previously and it had progressively enlarged with a concomitant deterioration of lung function. Although he had a history of chronic asthma, he had never been treated on a regular basis. After combination therapy, including regular tiopropium, a salmeterol/flucatisone inhaler, a salbutamol inhaler as needed, and oral theophylline therapy, right side bulla showed marked regression. This regression of bulla was associated with an improved forced expiratory volume in one second and normalization of residual volume. This case serves as a reminder to clinicians that medical treatment for underlying diseases should precede surgical consideration in patients with GBE.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hye Yun
authors.initials: HY
authors.lastname: Park
authors.forename: Seong Yong
authors.initials: SY
authors.lastname: Lim
authors.forename: Hye Kyeong
authors.initials: HK
authors.lastname: Park
authors.forename: So Young
authors.initials: SY
authors.lastname: Park
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Kim
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
mesh_terms: D000280:Administration, Inhalation; D000420:Albuterol / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D001249:Asthma / Q000150:complications / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006801:Humans; D019568:Lung, Hyperlucent / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D000068299:Salmeterol Xinafoate; D013806:Theophylline / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D001993:Bronchodilator Agents; D000068299:Salmeterol Xinafoate; D013806:Theophylline; D000420:Albuterol