국소적 기도폐쇄

(1) Blebs and Bullae Blebs : Small collection of gas within visceral pleura 주로 lung apex (> 1 cm) rupture → spontaneous pneumothorax Bullae : Larger airspaces in the lung parenchyma (> 1cm diameter) Causes : · Chronic obstructive bronchitis · Emphysema. diffuse · 상기 질환 없이도 올 수 있다. Clinical type Type 1: Subpleural location in apex, narrowed neck related paraseptal emphysema Type 2: Superficial location, broad neck : spontaneous pneumothorax와 관계 Type 3: deep within the lung substances - Type 2와 비슷 exaggerated form of emphysema Indications for bullectomy ⅰ) markedly impaired dyspnea pneumothorax infected bullae ⅱ) large but localized bullae (> 1/3 of affected lung) ⅲ) He dilution과 body plethysmography 로 FRC가 심한(e.g. up to 4L) 차이가 날 때 (2) Bronchogenic Cysts site : · mediastinum (대부분 subcarinal region의 mass로 나타남) · Lung parenchyma (대부분 lower lobes) acquired lung cyst (e.g. lung abscess)