0
Communications to the Editor |

Primary Spontaneous Pneumothorax Detected During a Medical Checkup FREE TO VIEW

Akihiro Maeda, MD, FCCP; Shinichi Ishioka, MD, FCCP; Masaharu Yoshihara, MD; Mitsuhiro Mihara, MD; Takuso Shigenobu, MD; Shigenobu Nakamura, MD
Author and Funding Information

Hiroshima University, Hiroshima, Japan

Correspondence to: Akihiro Maeda, MD, FCCP, Health Service Center, Hiroshima University, 1–7-1 Kagamiyama, Higashihiroshima 739-8521, Japan



Chest. 1999;116(3):847-848. doi:10.1378/chest.116.3.847-a
Text Size: A A A
Published online

To the Editor:

Primary spontaneous pneumothorax (PSP) is a common clinical problem that occurs in apparently healthy subjects. The incidence of PSP was reported to be 7.4 men per 100,000 population per year and 1.2 women per 100,000 population per year.1A small percentage of patients is considered to be asymptomatic,2 but no detailed study has yet been reported. We report here the incidence of asymptomatic PSP among young adults in Japan, detected during medical checkups for university students.

Medical checkups for students are provided every year at Hiroshima University, and 8,850 students visited the Health Service Center between April and May 1998. Three cases of PSP were detected by examining indirect chest radiographs (width, 100 × 100 mm) of 8,841 students (men, 5,357; women, 3,484). The three students with PSP were men with the following characteristics: age, 18, 19, and 20 years (mean and median among the total male students examined were 21.4 and 21.0 years, respectively [n = 5,357]); height, 1.80, 1.72, and 1.70 m (mean, 1.72 m; median, 1.72 m [n = 4,924]); and body mass index (BMI), 22.4, 17.3, and 17.3 (mean, 21.5; median, 21.1[ n = 4,924]), respectively. Two of the students had never smoked. The detailed history, obtained after diagnosis, revealed that two of the subjects had noticed chest pain around the time of their checkup. These two subjects showed spontaneous improvement on chest radiographs taken 2 to 3 weeks after diagnosis, while the remaining subject with massive pneumothorax (Fig 1 ) was admitted to a hospital for aspiration treatment.

Only two cases of PSP had been detected among a total of 69,542 students during checkups at our center between 1989 and 1997. We cannot explain the high incidence found in 1998, but these cases may support the hypothesis of PSP clustering reported by Smit et al.3 Our findings suggest that the percentage of asymptomatic PSP is not negligible and that some cases may require medical intervention. PSP should be considered in the differential diagnosis of young men with a greater-than-average height or low BMI who complain of generalized malaise.

Figure Jump LinkFigure 1. An indirect chest radiograph of a university student taken during a medical checkup. The visceral pleural line is clearly seen with the absence of vascular markings beyond the pleural line. The estimated size of the pneumothorax is 50%.Grahic Jump Location

References

Melton, LJ, Hepper, NGG, Offord, KP (1979) Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974.Am Rev Respir Dis120,1379-1382
 
Peters, JI, Sako, EY Pneumothorax. Fishman, AP Elias, JA Fishman, JAet al eds.Fishman’s pulmonary diseases and disorders 3rd ed.1998,1439-1451 McGraw-Hill. New York, NY:
 
Smit, HJM, Devillé, WL, Schramel, FMNH, et al Spontaneous pneumothorax: predictable mini-epidemics [letter]? Lancet. 1997;;350 ,.:1450
 

Figures

Figure Jump LinkFigure 1. An indirect chest radiograph of a university student taken during a medical checkup. The visceral pleural line is clearly seen with the absence of vascular markings beyond the pleural line. The estimated size of the pneumothorax is 50%.Grahic Jump Location

Tables

References

Melton, LJ, Hepper, NGG, Offord, KP (1979) Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974.Am Rev Respir Dis120,1379-1382
 
Peters, JI, Sako, EY Pneumothorax. Fishman, AP Elias, JA Fishman, JAet al eds.Fishman’s pulmonary diseases and disorders 3rd ed.1998,1439-1451 McGraw-Hill. New York, NY:
 
Smit, HJM, Devillé, WL, Schramel, FMNH, et al Spontaneous pneumothorax: predictable mini-epidemics [letter]? Lancet. 1997;;350 ,.:1450
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543