Clinical significance of para‐carinal air cysts in patients with pleuroparenchymal fibroelastosis: The relationship with pneumomediastinum and pneumothorax

Abstract Background Para‐tracheal or para‐carinal air cysts (PACs) are often asymptomatic and usually detected incidentally by methods such as computed tomography. Their clinical significance is unclear in patients with pleuroparenchymal fibroelastosis (PPFE). Methods We evaluated the clinical signi...

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Main Authors: Hideaki Yamakawa, Shintaro Sato, Hiroki Ohta, Makiko Takatsuka, Kenji Kusano, Rie Kawabe, Tomohiro Oba, Keiichi Akasaka, Masako Amano, Jun Araya, Hiroki Sasaki, Hidekazu Matsushima
Format: Article
Language:English
Published: Wiley 2023-08-01
Series:The Clinical Respiratory Journal
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Online Access:https://doi.org/10.1111/crj.13671
Description
Summary:Abstract Background Para‐tracheal or para‐carinal air cysts (PACs) are often asymptomatic and usually detected incidentally by methods such as computed tomography. Their clinical significance is unclear in patients with pleuroparenchymal fibroelastosis (PPFE). Methods We evaluated the clinical significance of PACs in PPFE and their relationship with pneumomediastinum or pneumothorax. Results In total, 50 patients had PPFE and 34 (68%) had PACs. Most PACs were para‐carinal (n = 30). A para‐tracheal air cyst was detected in only nine patients, which included five patients having both para‐carinal and para‐tracheal air cysts. Overall median survival was 24.7 months. Survival was not significantly different between the patients with [PACs(+)] and without PACs (P = 0.268). A high frequency (64%) of the complication of pneumomediastinum or pneumothorax occurred in the overall population during follow‐up. Pneumomediastinum/pneumothorax occurred significantly more frequently in patients with PACs(+) than in those without (76.5% vs. 37.5%; P = 0.012). PACs(+) was the only significant risk factor for pneumomediastinum/pneumothorax. Conclusions Our data showed that PACs commonly occur in patients with PPFE, and most PACs were para‐carinal air cysts. Additionally, PACs(+) was a significant risk factor for pneumomediastinum/pneumothorax; therefore, clinicians should be more aware of these complications during follow‐up examination, particular in PACs(+) patients with PPFE.
ISSN:1752-6981
1752-699X