Vanishing lung syndrome mistaken for bilateral spontaneous pneumothorax

A 44-year-old male smoker presented with acute shortness of breath. The patient's vital signs were stable and his oxygen saturation was 87% at room air. A chest X-ray (CXR) showed bilateral apical hyperlucencies diagnosed as bilateral spontaneous pneumothorax (figure 1). He underwent bilateral16-French chest tubes placement. Follow-up CXR failed to show improvement (figure 2). A chest CT scan was performed and showed bilateral large bullae consistent with vanishing lung syndrome (VLS) (figure 3). The patient underwent a video-assisted thoracoscopy and bullectomy (figure 4). Figure 1 Close-up view of the admission chest X-ray showing …