Fujibayashi Yusuke, Ogawa Hiroyuki, Nishio Wataru, Nishikubo Megumi, Nishioka Yuki, Tane Shinya, Kitamura Yoshitaka, Yoshimura Masahiro
Hyogo Cancer Center, 13-70, Kitaouji-cho, Japan.
Respir Med Case Rep. 2020 Jun 6;30:101119. doi: 10.1016/j.rmcr.2020.101119. eCollection 2020.
A pneumatocele is a cystic change of the lung that is caused by a check valve in the bronchiole due to infection, trauma and positive-pressure ventilation. We herein report a case of pneumatocele triggered by using of continuous positive airway pressure (CPAP) for sleep apnea syndrome (SAS) after pulmonary resection. A 69-year-old man underwent right upper lobectomy for lung cancer and developed interstitial pneumonia (IP) 10th postoperative day (POD). He was treated with steroid pulse therapy (solmedrol 500 mg × 3 days), and thereafter with oral steroid therapy (predonin 30mg/day). Well responded to the steroid therapy, IP was improved. However, he noticed bloody sputum 29th POD, and chest computed tomography showed a giant cystic lesion on the dorsal right lower lobe. We resected the cyst and the pathological findings revealed that the cystic lesion was pneumatocele, and CPAP was strongly suspected of triggering this disease.
肺气囊是一种肺部的囊性改变，由细支气管中的单向活瓣因感染、创伤和正压通气引起。我们在此报告一例肺切除术后因使用持续气道正压通气（CPAP）治疗睡眠呼吸暂停综合征（SAS）引发肺气囊的病例。一名69岁男性因肺癌接受了右上叶切除术，术后第10天发生间质性肺炎（IP）。他接受了类固醇冲击疗法（甲强龙500mg×3天），此后接受口服类固醇疗法（强的松龙30mg/天）。对类固醇疗法反应良好，IP有所改善。然而，术后第29天他出现血痰，胸部计算机断层扫描显示右肺下叶背侧有一个巨大的囊性病变。我们切除了囊肿，病理检查结果显示该囊性病变为肺气囊，强烈怀疑是CPAP引发了此病。
