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Large, right lower lobe pneumatocele is shown, compromising ventilation in a premature infant with RDS and superimposed RSV pneumonitis.

A pneumatocele is a cavity in the lung parenchyma filled with air that may result from pulmonary trauma during mechanical ventilation.^[1]

Cause

A pneumatocele results when a lung laceration, a cut or tear in the lung tissue, fills with air.^[2] A rupture of a small airway creates the air-filled cavity.^[1] Pulmonary lacerations that fill with blood are called pulmonary hematomas.^[2] In some cases, both pneumatoceles and hematomas exist in the same injured lung.^[3] A pneumatocele can become enlarged, for example when the patient is mechanically ventilated or has acute respiratory distress syndrome, in which case it may not go away for months.^[3]

Diagnosis

Diagnosis can be made using chest X-ray; the lesion shows up as a small, round area filled with air.^[1] Computed tomography can give a more detailed understanding of the lesion.^[1] Differential diagnoses, other conditions that could cause similar symptoms as pneumatocele, include lung cancer, tuberculosis, and a lung abscess^[1] in the setting of Hyper IgE syndrome (aka Job's syndrome) or on its own, often caused by Staphylococcus aureus infection during cystic fibrosis.

Management and treatment

Treatment typically is supportive and includes monitoring and observation.^[1]

References

^ ^a ^b ^c ^d ^e ^f Atluri P, Karakousis GC, Porrett PM, Kaiser LR (2005). The Surgical Review: An Integrated Basic and Clinical Science Study Guide (Recall Series). Hagerstown, MD: Lippincott Williams & Wilkins. p. 376. ISBN 0-7817-5641-3.
^ ^a ^b White C, Stern EJ (1999). Chest Radiology Companion. Hagerstown, MD: Lippincott Williams & Wilkins. pp. 80, 176. ISBN 0-397-51732-7. Retrieved 2008-04-30.
^ ^a ^b Gavelli G, Canini R, Bertaccini P, Battista G, Bnà C, Fattori R (June 2002). "Traumatic injuries: imaging of thoracic injuries". European Radiology 12 (6): 1273–1294. doi:10.1007/s00330-002-1439-6. PMID 12042932.

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2. 肺結節のCTおよびPET computed tomographic and positron emission tomographic scanning of pulmonary nodules
3. 多発性結節性病変の鑑別診断および評価 differential diagnosis and evaluation of multiple pulmonary nodules
4. 原発性免疫不全症の肺合併症 pulmonary complications of primary immunodeficiencies
5. 先天性肺気道（嚢胞性腺腫様）形成異常 congenital pulmonary airway cystic adenomatoid malformation

English Journal

FLCN gene-mutated renal cell neoplasms: mother and daughter cases with a novel germline mutation.

Nagashima Y, Furuya M, Gotohda H, Takagi S, Hes O, Michal M, Grossmann P, Tanaka R, Nakatani Y, Kuroda N.SourceDepartment of Molecular Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. ynagas@med.yokohama-cu.ac.jp
International journal of urology : official journal of the Japanese Urological Association.Int J Urol.2012 May;19(5):468-70. doi: 10.1111/j.1442-2042.2011.02945.x. Epub 2011 Dec 29.
Birt-Hogg-Dubé syndrome is a familial genodermatosis, of which patients frequently develop renal neoplasms, fibrofolliculomas and pneumatocele. Here, we report a mother and daughter with renal neoplasms surgically resected (69 and 46 years-of-age at surgery, respectively). The mother's tumor was di
PMID 22211584

Cerebral Infarct Complicating Traumatic Pneumatocele: A Rare Sequela Following Blunt Chest Trauma.

Kesieme E, Feldmann M, Welcker K, Linder A, Prisadov G.SourceIrrua Specialist Teaching Hospital-Thoracic Surgery, Irrua, Nigeria.
The Thoracic and cardiovascular surgeon.Thorac Cardiovasc Surg.2012 May 1. [Epub ahead of print]
Systemic air embolism is known to rarely complicate blunt chest trauma. However, cerebral infarction caused by air emboli possibly originating from a traumatic pneumatocele has not been previously reported. We report a case of a 46-year-old woman who sustained blunt chest trauma with multiple rib an
PMID 22549758

Japanese Journal

遅発性気道出血に対し肺部分切除術を要した外傷性仮性肺嚢胞の1例

瀧口徹,岩瀬史明,小林辰輔,宮崎善史,牧真彦,松本学,加藤頼子
日本救急医学会雑誌 25(1), 29-35, 2014
症例は47歳の男性。バイク走行中に普通乗用車と衝突し受傷した。ドクターカー接触時，SpO<SUB>2</SUB>の低下と動揺胸郭がみられたため気管挿管を行った。病院到着後に低酸素血症と右気胸のため，胸腔ドレーンを挿入した。CTでは右上葉と右下葉に巨大な外傷性仮性肺嚢胞を認めた。入院後，人工呼吸器管理を続け，呼吸状態は安定していたため徐々にウィーニングしたが，遅発性に嚢胞が拡 …
NAID 130004542390