{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:39:16Z","timestamp":1791632356868,"version":"4.3.4"},"reference-count":98,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>This review focuses on the diverse etiologies of secondary spontaneous pneumothorax (SSP) and the crucial role of imaging in their diagnosis. Unlike primary spontaneous pneumothorax (PSP), which is typically due to ruptured blebs, SSP results from a wide array of underlying pulmonary conditions that can pose significant diagnostic challenges. These include infections like tuberculosis, airway diseases such as chronic obstructive pulmonary disease, malignancies (primary and metastatic), interstitial lung diseases like sarcoidosis, cystic lung diseases such as lymphangioleiomyomatosis, and connective tissue disorders. In women, catamenial pneumothorax secondary to endometriosis should be considered. The role of radiologists is crucial in uncovering these underlying conditions. While chest radiography is the initial imaging modality, computed tomography (CT) provides superior sensitivity for detecting subtle parenchymal abnormalities. Advanced techniques like photon-counting detector CT offer further benefits, including enhanced spatial resolution, reduced noise, and lower radiation dose, potentially revealing underlying causes that might be missed with conventional CT. This enhanced visualization of subtle parenchymal changes, small airways, and vascular structures can be the key to diagnosing the underlying cause of pneumothorax. Recognizing the diverse etiologies of SSP and utilizing advanced imaging techniques is paramount for accurate diagnosis, appropriate management, and improved patient outcomes.<\/jats:p>","DOI":"10.3390\/tomography11110125","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T08:57:55Z","timestamp":1762765075000},"page":"125","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous Pneumothorax: A Review of Underlying Etiologies and Diagnostic Imaging Modalities"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3710-3356","authenticated-orcid":false,"given":"Rupali","family":"Jain","sequence":"first","affiliation":[{"name":"Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Kandula","sequence":"additional","affiliation":[{"name":"Nemours Alfred I. duPont Hospital for Children, Wilmington, DE 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drew A.","family":"Torigian","sequence":"additional","affiliation":[{"name":"Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8504-8764","authenticated-orcid":false,"given":"Achala","family":"Donuru","sequence":"additional","affiliation":[{"name":"Hospital of University of Pennsylvania, Philadelphia, PA 19104, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,7]]},"reference":[{"key":"ref_1","first-page":"S372","article-title":"Pneumothorax: From definition to diagnosis and treatment","volume":"6","author":"Zarogoulidis","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.ccm.2021.08.007","article-title":"Pneumothorax: Classification and Etiology","volume":"42","author":"Huan","year":"2021","journal-title":"Clin. Chest Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1183\/09031936.00219214","article-title":"ERS task force statement: Diagnosis and treatment of primary spontaneous pneumothorax","volume":"46","author":"Tschopp","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1159\/000135932","article-title":"Pneumothorax","volume":"76","author":"Noppen","year":"2008","journal-title":"Respiration"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"100994","DOI":"10.1016\/j.lanepe.2024.100994","article-title":"Trends in incidence of pneumothorax in England before, during and after the COVID-19 pandemic (2017\u20132023): A population-based observational study","volume":"44","author":"Zhong","year":"2024","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1183\/09059180.00005310","article-title":"Spontaneous pneumothorax: Epidemiology, pathophysiology and cause","volume":"19","author":"Noppen","year":"2010","journal-title":"Eur. Respir. Rev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1136\/thorax.55.8.666","article-title":"Epidemiology of pneumothorax in England","volume":"55","author":"Gupta","year":"2000","journal-title":"Thorax"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1378\/chest.92.6.1009","article-title":"Smoking and the increased risk of contracting spontaneous pneumothorax","volume":"92","author":"Bense","year":"1987","journal-title":"Chest"},{"key":"ref_9","first-page":"1379","article-title":"Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950 to 1974","volume":"120","author":"Melton","year":"1979","journal-title":"Am. Rev. Respir. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1864","DOI":"10.1007\/s00247-024-06053-w","article-title":"Spontaneous pneumothorax in children: A radiological perspective","volume":"54","author":"Ayaz","year":"2024","journal-title":"Pediatr. Radiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1183\/09031936.93.04030324","article-title":"Independent risk factors for cumulative recurrence rate after first spontaneous pneumothorax","volume":"4","author":"Lippert","year":"1991","journal-title":"Eur. Respir. J."},{"key":"ref_12","first-page":"365","article-title":"Spontaneous pneumothorax in chronic obstructive pulmonary disease: Complications, treatment and recurrences","volume":"71","author":"Videm","year":"1987","journal-title":"Eur. J. Respir. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1183\/09031936.97.10061372","article-title":"Current aspects of spontaneous pneumothorax","volume":"10","author":"Schramel","year":"1997","journal-title":"Eur. Respir. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1136\/thx.52.9.805","article-title":"Recurrence of primary spontaneous pneumothorax","volume":"52","author":"Sadikot","year":"1997","journal-title":"Thorax"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1007\/s00268-016-3508-z","article-title":"Recurrent Primary Spontaneous Pneumothorax is Common Following Chest Tube and Conservative Treatment","volume":"40","author":"Olesen","year":"2016","journal-title":"World J. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1800864","DOI":"10.1183\/13993003.00864-2018","article-title":"Recurrence rates in primary spontaneous pneumothorax: A systematic review and meta-analysis","volume":"52","author":"Walker","year":"2018","journal-title":"Eur. Respir. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1164\/rccm.201807-1212CI","article-title":"The Genetics of Pneumothorax","volume":"199","author":"Boone","year":"2019","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.jtcvs.2008.12.019","article-title":"The impact of smoking in primary spontaneous pneumothorax","volume":"138","author":"Cheng","year":"2009","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1093\/ejcts\/ezx160","article-title":"Cannabis increased the risk of primary spontaneous pneumothorax in tobacco smokers: A case-control study","volume":"52","author":"Katballe","year":"2017","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Stefani, A., Aramini, B., Baraldi, C., Pellesi, L., Della Casa, G., Morandi, U., and Guerzoni, S. (2020). Secondary spontaneous pneumothorax and bullous lung disease in cannabis and tobacco smokers: A case-control study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0230419"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1053\/j.ro.2023.06.004","article-title":"Pneumothorax: Imaging Diagnosis and Etiology","volume":"58","author":"Kanne","year":"2023","journal-title":"Semin. Roentgenol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e230079","DOI":"10.1148\/rg.230079","article-title":"Pictorial Review of Pleural Disease: Multimodality Imaging and Differential Diagnosis","volume":"44","author":"Yamada","year":"2024","journal-title":"RadioGraphics"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e231986","DOI":"10.1148\/radiol.231986","article-title":"Photon-counting CT in Thoracic Imaging: Early Clinical Evidence and Incorporation Into Clinical Practice","volume":"310","author":"Fletcher","year":"2024","journal-title":"Radiology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"100538","DOI":"10.1016\/j.ejro.2023.100538","article-title":"Photon-counting detector CT allows significant reduction in radiation dose while maintaining image quality and noise on non-contrast chest CT","volume":"11","author":"Donuru","year":"2023","journal-title":"Eur. J. Radiol. Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1148\/radiol.2018172656","article-title":"Photon-counting CT: Technical Principles and Clinical Prospects","volume":"289","author":"Willemink","year":"2018","journal-title":"Radiology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s13244-016-0486-5","article-title":"Demystifying the persistent pneumothorax: Role of imaging","volume":"7","author":"Chaturvedi","year":"2016","journal-title":"Insights Imaging"},{"key":"ref_27","first-page":"207","article-title":"Congenital pulmonary airway malformation (cpam) mimicking an spontaneous pneumothorax in a newborn","volume":"34","year":"2021","journal-title":"Cir. Pediatr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"555","DOI":"10.2214\/ajr.162.3.8109495","article-title":"Panlobular pulmonary emphysema caused by i.v. injection of methylphenidate (Ritalin): Findings on chest radiographs and CT scans","volume":"162","author":"Stern","year":"1994","journal-title":"Am. J. Roentgenol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1183\/09031936.00128910","article-title":"Spontaneous pneumothorax and tuberculosis: Long-term follow-up","volume":"38","author":"Freixinet","year":"2011","journal-title":"Eur. Respir. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.hrtlng.2021.01.020","article-title":"Spontaneous pneumothorax: An emerging complication of COVID-19 pneumonia","volume":"50","author":"Ekanem","year":"2021","journal-title":"Heart Lung"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"E383","DOI":"10.1148\/radiol.2021211396","article-title":"CT of Post-Acute Lung Complications of COVID-19","volume":"301","author":"Solomon","year":"2021","journal-title":"Radiology"},{"key":"ref_32","first-page":"S377","article-title":"Human immunodeficiency virus infection and pneumothorax","volume":"6","author":"Terzi","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"W555","DOI":"10.2214\/AJR.11.7329","article-title":"Pneumocystis jiroveci pneumonia: High-resolution CT findings in patients with and without HIV infection","volume":"198","author":"Kanne","year":"2012","journal-title":"Am. J. Roentgenol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"107672","DOI":"10.1016\/j.rmed.2024.107672","article-title":"The risk of secondary spontaneous pneumothorax in patients with chronic obstructive pulmonary disease in Taiwan","volume":"228","author":"Liao","year":"2024","journal-title":"Respir Med."},{"key":"ref_35","first-page":"S480","article-title":"Pneumothorax in cystic fibrosis","volume":"6","author":"Kioumis","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1378\/chest.123.1.217","article-title":"Pneumothorax in cystic fibrosis","volume":"123","author":"Flume","year":"2003","journal-title":"Chest"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e240008","DOI":"10.1148\/rg.240008","article-title":"Update on the Role of Chest Imaging in Cystic Fibrosis","volume":"44","author":"Bugenhagen","year":"2024","journal-title":"RadioGraphics"},{"key":"ref_38","first-page":"S152","article-title":"Pneumothorax and asthma","volume":"6","author":"Porpodis","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e23779","DOI":"10.1097\/MD.0000000000023779","article-title":"Long-term risk of pneumothorax in asthmatic children: A 12-year population-based cohort study","volume":"99","author":"Lin","year":"2020","journal-title":"Medicine"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1510\/icvts.2011.273201","article-title":"Pneumothorax associated with treatment for pulmonary malignancy","volume":"13","author":"Maniwa","year":"2011","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.ajem.2010.09.014","article-title":"Secondary spontaneous pneumothorax: Which associated conditions benefit from pigtail catheter treatment?","volume":"30","author":"Chen","year":"2012","journal-title":"Am. J. Emerg. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1023\/A:1008323632078","article-title":"Spontaneous pneumothorax in malignancy: A case report and review of the literature","volume":"11","author":"Srinivas","year":"2000","journal-title":"Ann. Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1378\/chest.09-2292","article-title":"A comprehensive review of spontaneous pneumothorax complicating sarcoma","volume":"138","author":"Hoag","year":"2010","journal-title":"Chest"},{"key":"ref_44","first-page":"E252","article-title":"Spontaneous pneumothorax as the first manifestation of lung cancer: Two case report","volume":"7","author":"Choi","year":"2015","journal-title":"J. Thorac. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s11748-020-01423-1","article-title":"Spontaneous pneumothorax associated with cavitating pulmonary metastasis from breast cancer: A case report and literature review","volume":"69","author":"Hashinokuchi","year":"2021","journal-title":"Gen. Thorac. Cardiovasc. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/1759-7714.12410","article-title":"Occult primary pulmonary synovial sarcoma presenting as recurrent spontaneous pneumothorax and explosive progression","volume":"8","author":"Guo","year":"2017","journal-title":"Thorac. Cancer"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"757","DOI":"10.2214\/ajr.184.3.01840757","article-title":"Pulmonary disease in patients with AIDS: High-resolution CT and pathologic findings","volume":"184","author":"Marchiori","year":"2005","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Yamazaki, R., Nishiyama, O., Gose, K., Saeki, S., Sano, H., Iwanaga, T., and Tohda, Y. (2021). Pneumothorax in patients with idiopathic pulmonary fibrosis: A real-world experience. BMC Pulm. Med., 21.","DOI":"10.1186\/s12890-020-01370-w"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"W464","DOI":"10.2214\/AJR.10.7309","article-title":"Lung CT: Part 2, The interstitial pneumonias\u2014Clinical, histologic, and CT manifestations","volume":"199","author":"Ferguson","year":"2012","journal-title":"Am. J. Roentgenol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e156","DOI":"10.4187\/respcare.02929","article-title":"Severe excessive dynamic airway collapse in a patient with primary Sj\u00f6gren\u2019s syndrome","volume":"59","author":"Ismael","year":"2014","journal-title":"Respir. Care"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1378\/chest.100.6.1733","article-title":"Lymphocytic interstitial pneumonitis presenting as recurrent pneumothoraces","volume":"100","author":"Parker","year":"1991","journal-title":"Chest"},{"key":"ref_52","first-page":"S466","article-title":"Pneumothorax in sarcoidosis","volume":"6","author":"Manika","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1148\/rg.306105512","article-title":"Pulmonary sarcoidosis: Typical and atypical manifestations at high-resolution CT with pathologic correlation","volume":"30","author":"Criado","year":"2010","journal-title":"Radiographics"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1007\/s00408-018-0155-1","article-title":"Pneumothorax in Patients with Pulmonary Langerhans Cell Histiocytosis","volume":"196","author":"Radzikowska","year":"2018","journal-title":"Lung"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1513\/AnnalsATS.201606-459OC","article-title":"Chest Computed Tomographic Image Screening for Cystic Lung Diseases in Patients with Spontaneous Pneumothorax Is Cost Effective","volume":"14","author":"Gupta","year":"2017","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1148\/rg.243045005","article-title":"From the archives of the AFIP: Pulmonary Langerhans cell histiocytosis","volume":"24","author":"Abbott","year":"2004","journal-title":"Radiographics"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1148\/rg.253055006","article-title":"From the archives of the AFIP: Lymphangioleiomyomatosis: Radiologic-pathologic correlation","volume":"25","author":"Abbott","year":"2005","journal-title":"Radiographics"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1148\/rg.210104","article-title":"Understanding Lymphatic Anatomy and Abnormalities at Imaging","volume":"42","author":"Lee","year":"2022","journal-title":"Radiographics"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1056\/NEJMc0707517","article-title":"Diagnostic potential of serum VEGF-D for lymphangioleiomyomatosis","volume":"358","author":"Young","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S1535-6108(02)00104-6","article-title":"Mutations in a novel gene lead to kidney tumors, lung wall defects, and benign tumors of the hair follicle in patients with the Birt-Hogg-Dub\u00e9 syndrome","volume":"2","author":"Nickerson","year":"2002","journal-title":"Cancer Cell"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1164\/rccm.200610-1483OC","article-title":"Lung cysts, spontaneous pneumothorax, and genetic associations in 89 families with Birt-Hogg-Dub\u00e9 syndrome","volume":"175","author":"Toro","year":"2007","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Johannesma, P.C., van den Borne, B.E.E.M., Gille, J.J.P., Nagelkerke, A.F., van Waesberghe, J.T.M., Paul, M.A., van Moorselaar, R.J.A., Menko, F.H., and Postmus, P.E. (2014). Spontaneous pneumothorax as indicator for Birt-Hogg-Dub\u00e9 syndrome in paediatric patients. BMC Pediatr., 14.","DOI":"10.1186\/1471-2431-14-171"},{"key":"ref_63","first-page":"e1","article-title":"CT findings of pulmonary cysts","volume":"76","year":"2021","journal-title":"Clin. Radiol."},{"key":"ref_64","first-page":"211","article-title":"Pleural effusion, pneumothorax, and lung entrapment in rheumatoid arthritis","volume":"21","author":"Komarla","year":"2015","journal-title":"J. Clin. Rheumatol. Pract. Rep. Rheum. Musculoskelet. Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1016\/j.ejrad.2015.07.008","article-title":"Intra-thoracic rheumatoid arthritis: Imaging spectrum of typical findings and treatment related complications","volume":"84","author":"Chansakul","year":"2015","journal-title":"Eur. J. Radiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1148\/rg.2021200091","article-title":"Thoracic Manifestations of Rheumatoid Arthritis","volume":"41","author":"Groner","year":"2021","journal-title":"RadioGraphics"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1378\/chest.07-2444","article-title":"High-resolution CT scan findings in patients with symptomatic scleroderma-related interstitial lung disease","volume":"134","author":"Goldin","year":"2008","journal-title":"Chest"},{"key":"ref_68","first-page":"193","article-title":"The Extrapulmonary Manifestations of Systemic Sclerosis on Chest High Resolution Computed Tomography","volume":"14","author":"Farrokh","year":"2015","journal-title":"Tanaffos"},{"key":"ref_69","first-page":"641","article-title":"Pleuropulmonary manifestations of ankylosing spondylitis","volume":"52","author":"Rosenow","year":"1977","journal-title":"Mayo Clin. Proc."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1148\/radiographics.20.6.g00nv031623","article-title":"Thoracic manifestations of systemic autoimmune diseases: Radiographic and high-resolution CT findings","volume":"20","author":"Mayberry","year":"2000","journal-title":"RadioGraphics"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1148\/rg.274065171","article-title":"Imaging of Marfan syndrome: Multisystemic manifestations","volume":"27","author":"Ha","year":"2007","journal-title":"RadioGraphics"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"6012","DOI":"10.21037\/jtd-21-1064","article-title":"Respiratory manifestations of Marfan syndrome: A narrative review","volume":"13","author":"Tun","year":"2021","journal-title":"J. Thorac. Dis."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1136\/jmg.2009.072785","article-title":"The revised Ghent nosology for the Marfan syndrome","volume":"47","author":"Loeys","year":"2010","journal-title":"J. Med. Genet."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"482","DOI":"10.2214\/AJR.11.6603","article-title":"Vascular complications of Ehlers-Danlos syndrome: CT findings","volume":"198","author":"Chu","year":"2012","journal-title":"Am. J. Roentgenol."},{"key":"ref_75","first-page":"S448","article-title":"Catamenial pneumothorax","volume":"6","author":"Visouli","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1164\/rccm.200704-587OC","article-title":"Catamenial and noncatamenial, endometriosis-related or nonendometriosis-related pneumothorax referred for surgery","volume":"176","author":"Alifano","year":"2007","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_77","first-page":"117","article-title":"Catamenial pneumothorax\u2014A review of the literature","volume":"13","author":"Sowa","year":"2016","journal-title":"Kardiochirurgia Torakochirurgia Pol. Pol. J. Cardio-Thorac. Surg."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.radcr.2017.09.003","article-title":"Catamenial pneumothorax caused by thoracic endometriosis","volume":"13","author":"Maniglio","year":"2018","journal-title":"Radiol. Case Rep."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.athoracsur.2011.09.024","article-title":"Pleural endometriosis and recurrent pneumothorax: The role of magnetic resonance imaging","volume":"93","author":"Marchiori","year":"2012","journal-title":"Ann. Thorac. Surg."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1056\/NEJMc1911995","article-title":"Imaging of Vaping-Associated Lung Disease","volume":"381","author":"Henry","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1186\/s13256-019-2215-4","article-title":"Recurrent spontaneous pneumothoraces and vaping in an 18-year-old man: A case report and review of the literature","volume":"13","author":"Bonilla","year":"2019","journal-title":"J. Med. Case Rep."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1007\/BF00256704","article-title":"Fatal pneumothorax associated with bleomycin-induced pulmonary fibrosis","volume":"17","author":"Doll","year":"1986","journal-title":"Cancer Chemother. Pharmacol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1136\/thx.53.2008.S20","article-title":"Diving and the risk of barotrauma","volume":"53","author":"Russi","year":"1998","journal-title":"Thorax"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"850","DOI":"10.4329\/wjr.v6.i11.850","article-title":"Spontaneous pneumomediastinum and Macklin effect: Overview and appearance on computed tomography","volume":"6","author":"Murayama","year":"2014","journal-title":"World J. Radiol."},{"key":"ref_85","first-page":"S435","article-title":"Acute respiratory distress syndrome and pneumothorax","volume":"6","author":"Terzi","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_86","first-page":"101841","article-title":"Simultaneous bilateral spontaneous pneumothorax in a patient with anorexia nervosa","volume":"43","author":"Uchida","year":"2023","journal-title":"Respir. Med. Case Rep."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1148\/rg.220018","article-title":"Sequelae of Eating Disorders at Imaging","volume":"42","author":"Solomon","year":"2022","journal-title":"RadioGraphics"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1002\/ajmg.1320400207","article-title":"On the inheritance of primary spontaneous pneumothorax","volume":"40","author":"Abolnik","year":"1991","journal-title":"Am. J. Med. Genet."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"e238694","DOI":"10.1136\/bcr-2020-238694","article-title":"Spontaneous pneumothorax as a clinical manifestation of neurofibromatosis type 1","volume":"14","author":"Lorentzen","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.rmed.2019.01.002","article-title":"Neurofibromatosis type 1: State-of-the-art review with emphasis on pulmonary involvement","volume":"149","author":"Zanetti","year":"2019","journal-title":"Respir. Med."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1164\/rccm.200501-143OC","article-title":"Nonsense mutations in folliculin presenting as isolated familial spontaneous pneumothorax in adults","volume":"172","author":"Graham","year":"2005","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1183\/09031936.93.03030342","article-title":"Familial spontaneous pneumothorax","volume":"3","author":"Grunnet","year":"1990","journal-title":"Eur. Respir. J."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1136\/emj.2006.039750","article-title":"Pulmonary involvement in Henoch-Schonlein purpura","volume":"23","author":"Soloukides","year":"2006","journal-title":"Emerg. Med. J."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1038\/gim.2014.11","article-title":"Loeys-Dietz syndrome: A primer for diagnosis and management","volume":"16","author":"MacCarrick","year":"2014","journal-title":"Genet. Med."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1148\/rg.2018170120","article-title":"Cardiovascular Manifestations and Complications of Loeys-Dietz Syndrome: CT and MR Imaging Findings","volume":"38","author":"Loughborough","year":"2018","journal-title":"RadioGraphics"},{"key":"ref_96","first-page":"737","article-title":"Spontaneous pneumothorax in children","volume":"66","author":"Goldman","year":"2020","journal-title":"Can. Fam. Physician"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1136\/adc.59.11.1046","article-title":"Pulmonary interstitial emphysema","volume":"59","author":"Greenough","year":"1984","journal-title":"Arch. Dis. Child."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1111\/ggi.13996","article-title":"Etiology and prognosis of spontaneous pneumothorax in the elderly","volume":"20","author":"Takahashi","year":"2020","journal-title":"Geriatr. Gerontol. Int."}],"container-title":["Tomography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2379-139X\/11\/11\/125\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T09:50:16Z","timestamp":1762768216000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2379-139X\/11\/11\/125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,7]]},"references-count":98,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["tomography11110125"],"URL":"https:\/\/doi.org\/10.3390\/tomography11110125","relation":{},"ISSN":["2379-139X"],"issn-type":[{"value":"2379-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,7]]}}}