Demet DOĞAN, Erce GÜLER
Medical Science and Discovery - 2026;13(4):71-76
Objective: Lung herniation is a rare and potentially underrecognized clinical entity characterized by protrusion of lung parenchyma through defects in the thoracic wall. It may arise in a variety of clinical settings, most commonly in association with chronic obstructive pulmonary disease (COPD), increased intrathoracic pressure, or prior thoracic interventions. In this study, we present three cases of lung herniation with distinct clinical backgrounds and imaging features, all diagnosed using thoracic computed tomography (CT). Case: Three patients diagnosed with lung herniation at our institution were retrospectively evaluated. The first case was a 67-year-old woman with chronic obstructive pulmonary disease (COPD) and prior lung surgery, in whom CT demonstrated intercostal herniation of the right middle lobe. The second case was a 51-year-old man with COPD and active smoking, showing anterolateral herniation of the right lower lobe with associated ground-glass opacities in the herniated parenchyma. The third case was a 48-year-old man with a history of mitral valve surgery, in whom non-contrast CT revealed focal herniation of the right middle lobe through a mild anterior thoracic wall defect, accompanied by adjacent subpleural reticular opacities. In all cases, CT enabled precise identification of the chest wall defect and associated parenchymal findings. None of the patients showed radiological evidence of incarceration. All patients were managed conservatively and remained clinically stable during 12 months of follow-up. Conclusion: Lung herniation is a rare and heterogeneous condition that may occur in various clinical settings, particularly in the presence of COPD, increased intrathoracic pressure, or prior surgery. CT plays a central role in diagnosis and risk assessment. Conservative management may be appropriate in selected asymptomatic patients, while treatment decisions should be individualized based on clinical and radiological findings.
