Vanishing Lung Syndrome

Department of Radiology, Bethune First Hospital, Jilin University, Changchun, China Correspondence: Dr Wei Liu, Department of Thoracic Surgery, Bethune First Hospital, Jilin University, No. 71 Xinmin Street, Changchun 130021, China. Telephone 86-431-88782973, fax 86-431-88782733, e-mail davidliuw@hotmail.com A 19-year-old woman was admitted to the emergency room with acute pleuritic chest pain. She had no significant medical history, but was a current smoker. Computed tomography of the chest revealed a giant bulla occupying more than three-quarters of the left hemithorax, compressing the residual lung and displacing the mediastinum toward the opposite side (Figure 1). The images were consistent with vanishing lung syndrome (VLS). At thoracotomy, a giant bulla (at least 20 cm in diameter) was present in the left upper lobe. Bullectomy was performed without incident, allowing re-expansion of the underlying lung (Figure 2). Pathological examination showed an enlarged airspace with paraseptal emphysema on the margin and infiltration of inflammatory cells. images in respiratory medicine