bullas Emphysema

I have just been diagnosed with bullas emphysema, well actually the radiologist told my primary care doctor, that I have it.  I had gone for an x-ray, because of a bad cough that would not go away and a bad sore throat.
My question is:  I had sarcoid back in the 60's (of the lung) 20 years ago when I went back for my check up my doctor told me it was gone, and not to worry that my lungs looked better than his. Now I see on the internet that bullas emphysema is caused by Sarcoid.  I have been getting the pneumonia shot for the 20 years, and basically I have had NO trouble what so ever with a cough or anything to do with my lungs. I smoked (not a chain smoker) between the age of 21 thru 29. I haven't picked up a cigarette since. I just can't even believe that I have this now.
When I was young I use to get pneumonia, bronchitis, at least 3 to 4 times a year. But nothing in the last 20 years. I was once diagnosed with Bohalms disease, or devils grip. I am in good shape, good weight, except being extremely sensitive to lactaid, I am perfectly healthy (*that is I was) my colestrial is a little high, but have low blood pressure.

[National Jewish Health]

You should first confirm the interpretation of the chest x-ray as showing bullous emphysema.  Bullae are air-filled cavities in the lung.  They can occur in the presence or absence of emphysema.  Bullous lung disease is characterized by the presence of bullae in one or both lung fields, with normal intervening lung.  Bullous emphysema is the presence of bullae in a person with chronic obstructive pulmonary disease (COPD) and is characterized by the presence of centrilobular emphysema in the non-bullous lung.  High resolution CT scanning can distinguish between the 2, as can pulmonary function tests (PFTs).  It can also identify infected cysts that can mimic bullae.

Sarcoidosis is a rare cause of large bullae but unlikely to follow complete radiologic clearing, especially with no symptoms of sarcoidosis in the 20 year interim.

I suggest that you request consultation with a lung specialist, also known as a pulmonologist, to review your x-ray, order a high resolution CT (HRCT) scan and pulmonary function tests (PFTs).  Depending on the size of the bullous, its impact on pulmonary function and the absence of a complication of the bullous, for example tumor formation, surgical removal of the bullae may or may not be a consideration.

Good luck.