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Pulmonary Apical Opacities on Thin-Section Computed Tomography: Relationship to Primary Spontaneous Pneumothorax in Young Male Patients and Corresponding Histopathologic Findings

Kobayashi, Noriko, Sudo, MD*; Nambu, Atsushi, PhD*; Kawamoto, Masashi, PhD; Hayashi, Takana, Yamakawa, PhD*; Watanabe, Masato, MD; Okumura, Takehiro, PhD; Fujino, Shozo, PhD; Aso, Tatsuya, PhD; Takahashi, Mikiko, PhD; Okabe, Yugo, MD§; Koyama, Hikari, MD§; Kohyama, Tadashi, PhD§; Tago, Masao, PhD*

Journal of Computer Assisted Tomography: January/February 2018 - Volume 42 - Issue 1 - p 33–38
doi: 10.1097/RCT.0000000000000649
Thoracic Imaging

Objective The purpose of this study was to test the hypothesis that apical opacities on computed tomography (CT) are related to occurrence of primary spontaneous pneumothorax (PSP) in young male patients.

Methods We compared the frequency of apical opacities on thin-section CT between 70 male patients with PSP (PSP group) and 74 male patients without a history of PSP (non-PSP group). We also evaluated histopathologic findings of 39 specimens from 37 surgical cases in the PSP group.

Results Apical opacities were significantly more frequent in the PSP group than in the non-PSP group (right side, P = 0.01; left side, P = 0.005). Histopathologically, subpleural band-like alveolar collapse was seen in 35 specimens (89.7%), which was always accompanied by fibroelastosis and fibroblastic foci.

Conclusions Apical opacities on CT were significantly associated with PSP in young male patients. These apical opacities histopathologically correspond to fibrotic pleural thickening with subpleural alveolar collapse.

From the Departments of *Radiology, †Clinical Diagnostic Pathology, ‡Surgery, and §Internal Medicine, Teikyo University Mizonokuchi Hospital, Kawasaki, Kanagawa Japan.

Received for publication February 27, 2017; accepted May 24, 2017.

Correspondence to: Noriko Sudo Kobayashi, MD, Department of Radiology, Teikyo University, Mizonokuchi Hospital 3-8-3 Mizonokuchi Takatsu-ku, Kawasaki City, Kanagawa 213-8507 Japan (e-mail:

The authors declare no conflict of interest.

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