Histologic Changes

The resected lung shows a thickened pleura that has two blebs in it (arrow marks the second space within the pleura). The lung parenchyma (bottom right) shows some chronic interstitial inflammation.

In another area, both a bleb and a subpleural bulla are present. Again, the pleura is thickened. The bulla results from destruction of alveolar walls (paraseptal emphysema). The bleb results from rupture of alveolar air into the interstitium and dissection into the pleura.

Both collections of air can rupture into the pleural space to cause pneumothorax.

Clinical summary Image 5

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