Case 25--Lung Volume Reduction Surgery in a 55-Year-Old Man

Clinical summary: A 55-year-old male smoker with emphysema was noted to have a left upper lobe nodule on CT. Bilateral lung volume reduction surgery on 11/13/98 included the nodule, which was considered to be cancer.

Pulmonary Function Test Results

Date

FEV1/FVC (L)--% (Normal >70%)

TLC (L)

DLCO (ml/mn/mmHg)

9/98

0.9 /3.6--25%

7.1

11 (40% predicted)

10/91

1.7/4--42%

--

15

Arterial blood gases: pH 7.45, PCO2 36, PO2 69, oxygen saturation on room air 95%. The airflow obstruction was not reversed by bronchodilators. What do these tests signify? Answer

Radiology | Image 1 | Image 2 | Discussion

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Interpretation: The severe obstructive ventilatory defect with decreased DLCO suggests emphysema.