[Pulmonary fibrosis and emphysema].

We report a case of combined pulmonary fibrosis and emphysema. This syndrome, including upper-lobe emphysema and pulmonary fibrosis of the lower lung was recently described in smokers or ex-smokers (mean age: 65 years). Exertional dyspnea is always present. Pulmonary functions are subnormal while carbon monoxyde transfer is reduced and exercise hypoxemia is present. High resolution CT-scan is key of diagnosis with upper lobes emphysema with diffuse infiltrating fibrosing disease at the bases. Pulmonary hypertension is present is almost 50% of patients, representing the principal negative pronostic factor. Five years survival is 54.6% (median survival 6, 1 years).