Hemorrhagic Complicated Giant Bullae

Abstract

Giant bullous emphysema (GBE) is a rare condition often seen in young smokers but may also occur in non-smokers. We present a 45-year-old non-smoking female with progressive dyspnea and a large cystic lesion detected in the right lower lobe on thoracic CT. The lesion was identified as a giant bulla without communication with the bronchial tree. A right lower lobectomy was performed due to its size and internal vascular structures. Histopathological examination confirmed bullous emphysema with hemorrhagic and congestion. The postoperative period was uneventful. This case highlights the importance of differentiating giant bullae from pneumothorax to avoid inappropriate chest tube placement. Surgical resection via thoracotomy or video-assisted thoracoscopic surgery (VATS) remains the definitive treatment for symptomatic cases.