000 Bronchiectasis

  • is an obstructive lung disease
    • Caused by
      •  infection
      • pneumonia
      • TB aspergillosis
      • smoking
      • radiation therapy
      • cystic fibrosis
      • immune disease
        • autoimmune
        • HIV/AIDS
    • Resulting in
      • permanent enlargement of parts of the airways

Apical Bronchiectasis – Possibly TB

APICAL BRONCHIECTASIS
CT scan through the apex of the lungs of a 100 year old female showing evidence of bilateral apical bronchiectasis (top) with correlative plain film findings in the plain film (below) The most common cause is TB. The MPA is enlarged consistent with the diagnosis of pulmonary hypertension.
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  • Emphysema
  • Smoking and Bronchiectasis –
      • Loss of ciliary function by cigarette smoke
      • Increase mucus production with decrease clearing
      • Increase infection

Saccular Bronchiectasis

Saccular Bronchiectasis
Ashley Davidoff MD TheCommonVein Bronchiectasis 001

 

56M copd bronchiectasis 01 CXR
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56M copd bronchiectasis 02 CXR
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56M copd bronchiectasis 03 CT
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56M copd bronchiectasis 03b CT
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56M copd bronchiectasis 04 CXR
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56M copd bronchiectasis 05
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56M copd bronchiectasis 06
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Mucus Filled airway with Distal Hyperinflation

Segmental and Subsegmental Bronchiectasis with extension of the disease process into the small airways characterised by centrilobular nodules
Ashley Davidoff MD TheCommonVein.net bronchiectasis 006b
Segmental and Subsegmental Bronchiectasis with extension of the disease process into the small airways characterised by centrilobular nodules and distal hyperinflation noted in the left lower lobe
Ashley Davidoff MD TheCommonVein.net bronchiectasis 005
Segmental and Subsegmental Bronchiectasis with mucoid impaction and areas of mosaic attenuation
Ashley Davidoff MD TheCommonVein.net bronchiectasis 006

 

Bronchiectasis and Atelectasis
Atelectasis and Bronchiectasis
68year old male presents with chronic cough. Chest Xray reveals evidence of tram tracking and bronchiectasis in the left lung with volume loss of the entire right lung with secondary hyperinflation of the right lung, and mediastinal shift. CT scan shows severe volume loss and hyperinflation of the right lung.
Ashley Davidoff MD TheCommonVein.net
Tree in Bud Sign Bronchopulmonary Aspergillosis (ABPA)
CT scan through the chest shows medium sized bronchi, bronchioles and small airways impacted with fluid. This collage is presented to reveal tree in bud changes resulting from impaction in the smaller terminal bronchioles and respiratory units. The tree-in-bud pattern also results in small centrilobular nodules connected to multiple branching linear structures of similar caliber from a single stalk. Originally it was felt to result from endobronchial spread of Mycobacterium tuberculosis, but is is now recognized in diverse entities including peripheral airway diseases caused by infection (bacterial, fungal, viral, or parasitic), congenital disorders, idiopathic disorders (obliterative bronchiolitis, pan bronchiolitis), aspiration or inhalation of foreign substances, immunologic disorders, connective tissue disorders and peripheral pulmonary vascular diseases such as neoplastic pulmonary emboli.
In this case there are also dilated medium sized airways, impacted with soft tissue characteristic of the finger in glove sign and most likely due to allergic bronchopulmonary aspergillosis (ABPA)
Ashley Davidoff MD Ashley Davidoff MD TheCommonVein.net
47113c01

 

Compare the two Sides
Mild LLL Bronchiectas
Compare the 2 bases
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Links and References

Milliron B, et al Bronchiectasis: Mechanisms and Imaging Clues of Associated Common and Uncommon Diseases RadioGraphicsVol. 35, No. 4 2015

 

Brent P. Little

Kartagener’s syndrome TCV page

Fleischner Society

Pathology.—Bronchiectasis is irreversible localized or diffuse bronchial dilatation, usually resulting from chronic infection, proximal airway obstruction, or congenital bronchial abnormality (,26). (See also traction bronchiectasis.)

Radiographs and CT scans.—Morphologic criteria on thin-section CT scans include bronchial dilatation with respect to the accompanying pulmonary artery (signet ring sign), lack of tapering of bronchi, and identification of bronchi within 1 cm of the pleural surface (,27) (,Fig 11). Bronchiectasis may be classified as cylindric, varicose, or cystic, depending on the appearance of the affected bronchi. It is often accompanied by bronchial wall thickening, mucoid impaction, and small-airways abnormalities (,27–,29). (See also signet ring sign.)