Pleuroparenchymal fibroelastosis (PPFE) is a rare pulmonary fibrosis that is clinically characterized by upperlobe
predominant fibrosis. PPFE is a slowly progressive disorder and its first symptom is dyspnea or dry cough. Chest
pain because of pneumothorax may be the first symptom in some patients. Patients with PPFE are slender with a flat rib
cage or abnormally narrowed anterior–posterior thoracic dimension. Decreases in forced vital capacity, total lung
capacity, and diffusing capacity are respiratory-function characteristics of PPFE, similar to those seen in idiopathic
pulmonary fibrosis (IPF). The most remarkable difference in clinical features between PPFE and IPF is imaging findings,
with upper-lobe-predominant lesions in PPFE and lower-lobe-predominant lesions in IPF.