2018 Volume 32 Issue 4 Pages 550-554
Case 1 was a 60-year-old man and case 2 was a 73-year-old man. They were referred to our hospital because of abnormal chest radiographs. Chest computed tomography (CT) showed reticular shadows in the bilateral lung, suggesting interstitial pneumonia (IP).
We performed a lung biopsy (lung wedge resection) with video-assisted thoracoscopic surgery for accurate pathological subtype analysis of IP. A few days after the removal of a chest tube, subcutaneous emphysema at the surgical site could be observed on a chest radiograph. Although lung collapse was not seen, marked mediastinal emphysema and subcutaneous emphysema were observed on CT.
Management with a tube was not performed since there were no space for chest tube insertion in the thoracic cavity. Careful observation by chest radiograph indicated spontaneous improvement in a few days.
This condition is considered to occur via air leakage due to subpleural alveolar damage caused by the endostaplars that pass through the hilum, leading to subcutaneous emphysema following mediastinal emphysema.
Generally, secondary mediastinal emphysema has been reported as a complication of IP. Subcutaneous/mediastinal emphysema without lung collapse should also be considered as one of the complications of lung biopsy for IP.
