Giant pulmonary bulla presenting as spontaneous pneumothorax in a non-smoker: A case report

Giant pulmonary bullae are large air-filled spaces within the lungs that can mimic pneumothorax and cause significant respiratory symptoms due to compression of adjacent lung tissue. While commonly associated with smoking and genetic conditions, idiopathic cases are rare. We report the case of a 54-year-old non-smoking male with no known risk factors who presented with a 1-week history of cough, chest pain, and exertional dyspnea. Chest radiograph revealed a left-sided pneumothorax, and an intercostal drain was inserted. Persistent non-expansion prompted high-resolution computed tomography (HRCT) of the chest, which identified a giant bulla in the left lower lobe with residual pneumothorax. The patient underwent successful bullectomy with good lung re-expansion and symptomatic improvement. Histopathology confirmed a benign pulmonary bulla. The patient had an uneventful recovery and remains stable on follow-up. This case emphasizes the importance of considering bullous lung disease in patients with spontaneous pneumothorax and highlights the role of HRCT and timely surgical intervention in achieving favorable outcomes.