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Postgraduate Education Corner: PULMONARY AND CRITICAL CARE PEARLS |

An 83-Year-Old Man With Bilateral Spontaneous Pneumothoraces and Multiple Cysts

Shambhu Aryal, MD; Chau Chu, MD; R. Scott Morehead, MD, FCCP
Author and Funding Information

From the Division of Pulmonary and Critical Care Medicine, University of Kentucky Medical Center, Lexington, KY.

Correspondence to: Shambhu Aryal, MD, Division of Pulmonary and Critical Care Medicine, University of Kentucky, 740 S Limestone St, Ste L543, Lexington, KY 40536; e-mail: sar222@uky.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(6):1536-1539. doi:10.1378/chest.10-2923
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Extract

An 83-year-old man was transferred to our medical center with bilateral pneumothoraces. A biopsy of a nonhealing scalp lesion was done 4 weeks previously, and the specimen showed high-grade angiosarcoma. During the subsequent staging evaluation a week later, he was found to have asymptomatic bilateral pneumothoraces and multiple pulmonary cysts that were not metabolically active on 18F-fluorodeoxyglucose (FDG)-PET scan. These findings were initially believed to be secondary to emphysema, and because of his absence of symptoms, the patient was sent home without intervention. However, several days later he developed a nonproductive cough with pleuritic chest pain and went to an outside ED. A chest radiograph again showed bilateral pneumothoraces, which resulted in placement of bilateral chest tubes with the subsequent transfer. His medical history was otherwise only remarkable for benign prostatic hypertrophy and cataracts. He admitted to smoking cigarettes remotely but denied fever, chills, leg swelling, palpitations, and syncope. He denied relevant occupational exposures, including asbestos.

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