SHM Converge Scientific Abstract ePoster Gallery-Autobullecotmy: The Spontaneous Resolution of a Pulmonary Bulla

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This case report describes a rare phenomenon called spontaneous pulmonary bulla regression, or “autobullectomy,” in a 73-year-old man with severe chronic lung disease. The patient had a significant smoking history, mixed bullous emphysema, pulmonary fibrosis requiring home oxygen, and stage IV adenosquamous carcinoma. He presented to the emergency department with three days of worsening shortness of breath, cough, and a positive home COVID-19 test. He remained stable on his baseline oxygen and was discharged with Paxlovid.<br /><br />A chest CT obtained during this visit unexpectedly showed complete regression of a giant right pulmonary bulla that had been present on imaging two years earlier. The patient later reported improvement in his overall respiratory symptoms during outpatient follow-up with pulmonology.<br /><br />The report emphasizes that giant bullae are usually associated with smoking-related emphysema and typically enlarge or remain stable over time; spontaneous shrinkage is uncommon and poorly understood. Possible explanations discussed in the literature include infection-related air-fluid changes, inflammation leading to connective tissue deposition, and regression associated with lung cancer. In this patient, COVID-19 infection may have played a role, although his underlying lung cancer could also have contributed.<br /><br />Overall, the case highlights a rare but clinically interesting form of bulla resolution that may be associated with symptom improvement, while noting that the exact mechanism remains uncertain and warrants further study.

Asset Subtitle

Yusuf Buxamusa

Meta Tag

Author List Amanda Rigdon, Graciela M. Luna, Joshua Tsai, Yusuf Buxamusa

Category Clinical Vignettes

Concept Bulla

Concept Giant Bulla

Concept Autobullectomy

Concept Smoking-Related Emphysema

Concept Imaging Finding

Distinguished Non-Finalist

Presenter Organization Lakeland Regional Health

Presenting Author Yusuf Buxamusa

Track Adult

Keywords

spontaneous pulmonary bulla regression

autobullectomy

giant pulmonary bulla

chronic lung disease

bullous emphysema

pulmonary fibrosis

COVID-19 infection

adenosquamous carcinoma

smoking history

chest CT

Bulla

Giant Bulla

Autobullectomy

Smoking-Related Emphysema

Imaging Finding