Nishioka M, Fukuoka M, Nakagawa K, Matsui K, Nakajima T
Department of Radiology, Osaka-prefectural Habikino Hospital, Japan.
Chest. 1993 Jul;104(1):160-3. doi: 10.1378/chest.104.1.160.
Spontaneous pneumothorax following chest irradiation is thought to occur in patients with radiation fibrosis several months or more after the completion of therapy. In the four patients presented herein, spontaneous pneumothorax was seen during or immediately after therapeutic radiation of lung cancer. All patients had bronchoscopic findings of bronchial obstruction by the tumor before treatment and radiographic improvement of atelectasis was observed during therapy. The interval between the improvement of atelectasis and the development of pneumothorax varied by less than three weeks. These common findings suggest that rupture of alveoli or emphysematous bullae and subsequent pneumothorax might be due to overinflation of the affected lung caused by partial bronchial obstruction. We should be aware of the occurrence of spontaneous pneumothorax following partial resolution of total bronchial obstruction.
胸部放疗后发生的自发性气胸被认为发生在放疗结束数月或更长时间后的放射性纤维化患者中。在本文介绍的4例患者中，自发性气胸出现在肺癌治疗性放疗期间或放疗后不久。所有患者在治疗前支气管镜检查均发现肿瘤导致支气管阻塞，且在治疗期间观察到肺不张在影像学上有所改善。肺不张改善与气胸发生之间的间隔时间相差不到3周。这些共同发现提示，肺泡或肺大疱破裂及随后发生的气胸可能是由于部分支气管阻塞导致患侧肺过度充气所致。我们应警惕全支气管阻塞部分缓解后发生自发性气胸的情况。
