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Images in thorax
Extrathoracic proof of intrathoracic trouble
  1. C Dickhoff1,
  2. K J Hartemink1,2,
  3. D J Slebos3,
  4. P Symersky4,
  5. A Vonk-Noordegraaf5
  1. 1Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands
  2. 2Department of Surgery, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
  3. 3Department of Pulmonology, University Medical Center Groningen, Groningen, The Netherlands
  4. 4Department of Cardiothoracic Surgery, Academic Medical Center, Amsterdam, The Netherlands
  5. 5Department of Pulmonology, VU University Medical Center, Amsterdam, The Netherlands
  1. Correspondence to Dr C Dickhoff, Department of Surgery, VU University Medical Center, 7F-005, postbox 7057, Amsterdam 1007 MB, The Netherlands; c.dickhoff{at},

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A 67-year-old man was referred to our hospital for bullectomy. Chest CT scan showed exhaustive bilateral bullous emphysema with a giant bulla in the right lung (figure 1). Cardiopulmonary exercise testing revealed a maximum exercise tolerance of 30 Watts and a progressive dynamic hyperinflation with an inspiratory capacity …

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