Pathologically Confirmed, Early-onset, Severe Chronic Obstructive Pulmonary Disease

Abstract

A 27-year-old man who had been a smoker since 14 years of age presented with exertional dyspnea. Approximately three years earlier, he had been occupationaly been exposed to an organic solvent and felt dyspnea during its use. He later developed severe dyspnea and received treatment for asthma. He had no relevant family history. Chest auscultation revealed decreased breath sounds without rales. Spirometry and highresolution computed tomography scans suggested a diagnosis of chronic obstructive pulmonary disease (COPD). Video-assisted thoracoscopic surgery performed to obtain a pathological diagnosis confirmed the presence of centrilobular emphysema. High susceptibility, smoking from an early age and organic solvent exposure may have caused early-onset COPD in this case. © 2012, The Japanese Society of Internal Medicine. All rights reserved.