The pulmonary bleb is a small subpleural air collection located within the visceral pleura layers. Symptoms of such lesions are usually preceded by spontaneous pneumothorax. Blebs are the result of air collapsing from small ruptures of terminal alveoli that have been dissected through the interstitium to form a small subpleural collection. Multiple blebs are frequently found. The majority of patients with blebs have no significant underlying lung disease. Pathologically, bleb formation occurs as a result of mechanical stress from increased intrathoracic pressure in lung tissue that is predisposed to deformation due to congenital connective tissue weakness.
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