Yoo Byeong A, Yoo Seungmo, Yun Jae Kwang, Choi Sehoon
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Chest Surg. 2023 May 5;56(3):216-219. doi: 10.5090/jcs.22.143. Epub 2023 Jan 30.
Pulmonary bullae usually grow slowly and have thin walls. However, we have observed 2 cases of abrupt bulla formation immediately after lobectomy and during surgery. The pathologic findings of what can be called visceral pleural detachment are quite distinctive: these bullae had a broad base connected to the lung, and their walls were thick, including the full extent of visceral pleural and peripheral alveolar tissues, which suggests that the visceral pleura were detached from the distal alveoli. High transpleural pressure might be the key factor in the pathogenesis of this type of bulla, unlike previously known types of bullous lung disease.
肺大疱通常生长缓慢且壁薄。然而，我们观察到2例在肺叶切除术后及手术过程中肺大疱突然形成的病例。所谓脏层胸膜分离的病理表现非常独特：这些肺大疱有一个与肺相连的宽基底，其壁增厚，包括整个脏层胸膜和外周肺泡组织，这表明脏层胸膜与远端肺泡分离。与先前已知的肺大疱性疾病类型不同，高跨胸膜压力可能是这类肺大疱发病机制中的关键因素。
