title: Bullous emphysema - Not always nicotine-related!: Unusual distribution of emphysema in a patient with a rare hobby.
abstract: In a patient admitted for further investigation of haemoptysis and dyspnoea and known emphysema of the lung, a remarkable distribution of emphysematous bullae could be detected on CT-imaging. Further history, besides smoking, revealed apnoea diving-activity during younger adult age. The distinct appearance of partially septated pleura-based bullae lead to the suspicion of a positive-pressure barotrauma of the lungs in the past, now complicated by infection and bleeding. This case highlights the importance of thorough questioning of the patient and underlines the consideration of differential diagnoses of emphysema.
authors.affiliation: Department of Respiratory Medicine, Sleep Medicine and Ventilation (Zentrum für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin), Deutsche Klinik für Diagnostik, Aukammalle 33, 65191 Wiesbaden, Germany.
authors.forename: Camilla
authors.initials: C
authors.lastname: Lüttecke-Hecht
authors.affiliation: Department of Respiratory Medicine, Sleep Medicine and Ventilation (Zentrum für Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin), Deutsche Klinik für Diagnostik, Aukammalle 33, 65191 Wiesbaden, Germany.
authors.forename: Tim O
authors.initials: TO
authors.lastname: Hirche
keywords: Apnoea-diving; Barotrauma; Bullae; Cigarette smoking; Emphysema