Acute Exacerbation of Pulmonary Fibrosis in Syndrome of Combined Pulmonary Fibrosis and Emphysema Following Lung Surgery : A Report of Two Cases

We herein report two cases of an acute exacerbation of pulmonary fibrosis in the syndrome of combined pulmonary fibrosis and emphysema (CPFE) following lung surgery, and also review the relevant literature. One is a 76-year-old man, who had been diagnosed with CPFE and lung cancer and undergone lobectomy. He was admitted to our hospital because of aggravation of dyspnea 50 days after lung surgery. The other is a 69-yearold man who had been diagnosed with pulmonary bulla, pulmonary emphysema and idiopathic interstitial pneumonia at 53 years old and was complicated by lung cancer. He underwent right lower lobectomy and presented with slight fever and desaturation 18 days after lung surgery. In both cases, chest computed tomography showed diffuse bilateral ground-glass opacities superimposed on preceding reticular opacities in the lower lung field. They were diagnosed as acute exacerbation of pulmonary fibrosis in CPFE.A strict followup is required, because the prevalence of lung cancer may be higher, and acute exacerbation may occur following lung surgery in CPFE patients. HRCT plays an important role in evaluating the occurrence of lung cancer at an early stage and for determining whether there is an acute exacerbation of pulmonary fibrosis in CPFE patients.Article信州医学雑誌 60(3): 149-156(2012)journal articl