Routine histological analysis of resected lung tissue in primary spontaneous pneumothorax -- is it justified?

Surgical management of spontaneous primary pneumothorax consists of pleurectomy together with resection of blebs or bullae. We analysed the utility of routine histological examination of these resected specimens. A consecutive series of 64 resected specimens were reviewed, of which 43 (67%) showed the presence of bullae or blebs. Of the remainder, 20 (31%) specimens showed no evidence of bullae or blebs and 1 specimen showed the presence of pneumatocoeles. Examination of the lung parenchyma revealed inflammation in 34 (53%) cases. In all 64 cases, the histological results did not result in a change in medical therapy. Although resected lung specimens from patients with primary spontaneous pneumothorax show diversity in their histological characteristics, we would question the utility of routine pathological analysis of resected lung specimens in primary spontaneous pneumothorax.