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Popcorn Lungs - Symptoms, Diagnosis, and Treatment

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Popcorn lung occurs due to the inflammation in the tiny air sacs. Read the article below to learn about the symptoms, diagnosis, and treatment of popcorn lung.

Written by

Dr. Saberitha

Medically reviewed by

Dr. Kaushal Bhavsar

Published At November 22, 2022
Reviewed AtJune 16, 2023

Introduction

Popcorn lung occurs due to the inflammation in the tiny air sacs. The bronchioles in the lungs are affected with bronchiolitis obliterans, often known as popcorn lung. The tiniest airways in the lungs are called bronchioles. If a person has this illness, infections or inhaling hazardous chemicals can cause the airways to become inflamed, damaged, and eventually scarred. Bronchioles are the smallest branches of the lungs. It ends in tiny sacs called alveoli. Rupture of the lining in these tiny air sacs and bronchioles causes inflammation. Hence, it is also known as bronchiolitis obliterans. The continuous irritation of the air passages (bronchi) leads to scarring. The bronchi become narrower and obstruct the oxygen flow. This condition is called popcorn lung. It usually occurs in middle-aged individuals, especially men.

What Are the Causes of a Popcorn Lung?

The irritation in the lungs because of hazardous chemical particles results in popcorn lungs. The inhalation of these toxins damages the lungs, air passages (bronchi), and air sacs (alveoli).

  • Flavoring Agents - Fumes are produced from the flavoring agents of food products like dairy products, popcorn, and candies. It coats the lining of the lung and causes popcorn lungs.

  • Cleaning Agents - Chlorine manufacturing units generate toxins and harm the lungs.

  • Construction Workers - The fumes produced from the solid metals during welding activate the chemical particles and produce toxins.

  • Industrial Workers - The complex dust particles are generated into the atmosphere during the manufacture of ammonia gas.

  • Fuel - Fossil fuels contain a chemical called sulfur dioxide. Burning fossil fuels releases sulfur into the atmosphere. It enters the lungs and causes inflammation.

  • Chemical Laboratories - The fumes produced from nitrous oxide and formaldehyde irritate the airways during inhalation.

  • Infectious Agents - Severe respiratory infections due to bacteria and viruses cause popcorn lungs.

  • Immune Reaction - Patients with hypersensitivity pneumonitis are more prone to popcorn lung. Hypersensitivity pneumonitis is a medical condition in which there is lung inflammation due to an allergy.

  • Drugs - Drugs like Penicillamine and Fluorouracil affect the lungs.

  • Transplant - Lung transplants or bone marrow transplants cause graft versus host disease. Because the body rejects the new organ from the donor through the immune reaction, this induces popcorn lungs after many years. It is the major cause of death in patients with popcorn lungs.

  • E-Cigarette - The presence of the chemical compound called diacetyl in the liquid of e-cigarettes results in popcorn lung. It is produced in the vapor while heating the liquid.

  • Marijuana - The smoke from marijuana contains acetaldehyde. It damages the mucosal lining of the throat and lungs. Continuous use of marijuana can worsen the condition of popcorn lungs.

What Are the Symptoms of Popcorn Lung?

The following symptoms appear within two to eight weeks after exposure to the chemical particles.

  • The chemical irritants produce inflammation in the air passages and result in wheezing.

  • There is an irritation in the skin, eyes, and mouth after exposure to the fumes.

  • The individual feels exhausted after physical activity.

  • The individual takes a deep breath to fill the lungs due to decreased working capacity of the lungs. So there is difficulty breathing.

  • There is an abnormal breathing pattern because the individual gasps for oxygen more frequently.

  • The irritants disrupt the throat lining and produce a dry cough.

How Is Popcorn Lung Diagnosed?

The medical professional asks about the past medical history and history of exposure to the chemicals during work. The confirmatory diagnostic tests for popcorn lung are as follows;

  • Chest X-Rays - The chest X-rays are used to diagnose popcorn lung. The radiographic image appears opaque (with white spots) due to the lung infection. The narrowing of the air passages can be identified in the chest X-rays.

  • Computed Tomography (CT Scan) - It provides additional information about the shape of popcorn lungs. The scarring in the lung tissue can be observed with computed tomography (CT scan). This is identified as a mosaic pattern by radiologists.

  • Biopsy - A special tool is used to remove the portion of the affected tissue from popcorn lungs. It is then examined for infection with the help of a microscope. The presence of abnormal cells observed under a microscope indicates popcorn lung.

  • Bronchoscopy - A lightweight tube is inserted into the air passages to observe the inflammation and scarring. The lung tissue and the cells are collected for analysis. The obstruction of air passages (bronchi) can also be identified using bronchoscopy.

  • Pulmonary Function Test - This is a noninvasive diagnostic technique used to determine lung function. There is a decreased airflow in the popcorn lung. There is an imbalance in the ratio of inhaled and exhaled air. The capacity of the lung is reduced due to bronchiolitis obliterans (inflammation of the air sacs).

What Are the Treatment Methods for Treating Popcorn Lung?

Life expectancy can be increased in patients with popcorn lungs by treating the symptoms at an earlier stage;

  • Corticosteroid Therapy - Steroids help in reducing inflammatory reactions in the body. Prednisone is commonly used to treat popcorn lung as it acts against inflammation.

  • Immunosuppressant Therapy - There is an increased immune reaction when the irritants enter the lungs. Immunosuppressive drugs are used to inhibit the immune mechanism in patients with popcorn lungs. Tacrolimus is the most commonly used medication in popcorn lungs.

  • Cough Suppressants - Dextromethorphan is used to reduce the cough reflex in patients.

  • Bronchodilators - The narrowing of bronchial tubes in popcorn lungs can be prevented by bronchodilators. It helps in the relaxation of breathing muscles and aids in breathing.

  • Montelukast - Drugs like Montelukast are used to treat respiratory conditions like wheezing in patients with popcorn lungs.

Conclusion

Popcorn lung occurs due to the inflammation in the tiny air sacs. The tissue scarring in the popcorn lungs is an irreversible condition. Popcorn lungs occur mostly in patients with lung transplants. It is a life-threatening disease, so have regular follow up with the surgeon after lung transplantation. Do not ignore the safety precautions during the occupation. The patient affected by popcorn lungs must stay away from an environment that contains harmful chemical irritants. The individual must stop using e-cigarettes to prevent further damage to the lungs. The workers in the construction sites or chemical industries must wear a protective mask to prevent inhalation of the irritants.

Frequently Asked Questions

1.

What Is the Cause of Airway Inflammation?

Airway inflammation can be caused by exposure to airborne infections, toxins, and diseases like asthma or bronchitis. In the airways, the receptors for IgE are present in the mast cells (resident cells of connective tissue containing many granules rich in histamine and heparin). When it is activated, the mast cells produce histamine, chemokines, proteases, leukotrienes, cytokines, and other substances, followed by immediate airway inflammation causing asthma symptoms.

2.

Can Airway Inflammation Subside on Its Own?

Yes, airway inflammation caused by acute bronchitis usually subsides on its own. It is usually caused by a virus for which antivirals are not prescribed. The symptoms gradually disappear as the inflammation goes down. However, if the bronchitis is caused by something else, treatment will be required treatment.

3.

What Are the Symptoms of Inflamed Airways?

The symptoms of airway inflammation include coughing, wheezing, shortness of breath, breathing difficulties, mucus in the airways, hypersensitive airways, swelling of the airway lining, chest pain, and tightness. Airway inflammation can be a short-lived problem or a long-term condition.

4.

How Is Airway Inflammation Managed?

The most effective treatment of airway inflammation includes inhaled corticosteroids. In some cases, oral corticosteroids can also be administered in addition to inhaled corticosteroids. Airway inflammation must be treated initially and aggressively by administering inhaled corticosteroids. 

5.

Is Airway Inflammation a Serious Condition?

Chronic bronchitis, a type of airway inflammation, is a severe condition when the bronchial tubes that carry air to and from the lungs remain inflamed for a period of time. It can further lead to cause a chronic cough.

6.

What Are the Two Most Common Diseases Causing Airway Inflammation?

The two most common diseases causing airway inflammation include asthma and chronic obstructive pulmonary disorder (COPD). The risk factors for these diseases include tobacco smoke, air pollution, dust, occupational chemicals, and frequent lower respiratory infections during childhood.

7.

Which Disorder Occurs as a Result of Chronic Airway Inflammation?

Chronic obstructive pulmonary disease (COPD) arises as a result of persistent inflammation in the airways. It is a progressive airflow limitation disorder caused by chronic airways and lung parenchyma inflammation. COPD has led to breathing difficulty in 16 million Americans who suffer from this condition.

8.

What Is the Function of the Bronchioles?

The bronchi are responsible for transporting air into the lungs, while the bronchioles, located at the end of the bronchi, direct air to small sacs within the lungs known as alveoli. The function of the bronchioles is to transfer air to around 300 million alveoli in the lungs. After inhalation, the oxygenated air is pulled into the bronchioles, and carbon dioxide is transferred to the alveoli expelled from the lungs during exhalation.

9.

What Are the Trachea and Bronchioles?

The trachea is the long tube connecting the larynx (voice box) to the bronchi. It is also known as the windpipe. The trachea further branches into two primary bronchi, which further branch into secondary and tertiary bronchi. These bronchi branch into several progressively smaller airways called bronchioles.

10.

Bronchioles Are Made of Which Type of Tissue?

Bronchioles are composed of smooth muscle layers that help in bronchodilatation and bronchoconstriction. The epithelial cells that majorly line the bronchial tree are ciliated columnar cells coupled by gap junctions and tightly packed.

11.

How Many Bronchioles Are Found in the Respiratory System?

The respiratory system consists of around 30,000 tiny bronchioles in each lung, further branching into the alveoli through alveolar ducts. The trachea and the two primary bronchi are known as the bronchial tree.

12.

Can Bronchioles Be Considered a Part of the Airway?

Yes, the bronchioles are part airways and are present in the lungs. The inhaled air is passed from the bronchioles through tiny ducts into elastic alveoli. These alveoli are covered by the alveolar-capillary membrane, which usually prevents liquid in the capillaries from entering the air sacs.

13.

What Is Considered the End of the Bronchioles?

The main airways bronchi branch into the smallest, called bronchioles, leading to tiny air sacs known as the alveoli. These alveoli are covered by the alveolar-capillary membrane, which usually prevents liquid in the capillaries from entering the air sacs.

14.

Is Mucus Present in the Bronchioles?

Yes, mucus is present on the inside walls of the bronchi in the form of sticky mucus that protects against damage from particles moving into the lungs. The mucus, also known as the airway surface liquid (ASL) is a thin layer of fluid covering the luminal surface of the airway.
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Dr. Kaushal Bhavsar
Dr. Kaushal Bhavsar

Pulmonology (Asthma Doctors)

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