Bronchiectasis
Bronchiectasis is defined as localized, irreversible dilatation of part of the bronchial tree. Involved bronchi are dilated, inflamed, and easily collapsible, resulting in airflow obstruction and impaired clearance of secretions. Bronchiectasis is associated with a wide range of disorders, but it usually results from necrotizing bacterial infections, such as infections caused by the Staphylococcus orKlebsiella species or Bordetella pertussis.
Hemoptysis is common and may occur in as many as 50% of patients. Episodic hemoptysis with little to no sputum production (dry bronchiectasis) is usually a sequela of tuberculosis. However, massive hemoptysis may occur; bleeding usually originates in dilated bronchial arteries, which contain blood at systemic (rather than pulmonary) pressures.
Diagnosis of bronchiectasis is based on a clinical history of daily viscid sputum production and characteristic computed tomography (CT) scan findings
Sub types
Sub types
According to macroscopic morphology, three types have been described, which also represent a spectrum of severity .
- cylindrical : bronchi have a uniform calibre, do not taper and have parallel walls (tram track sign and signet ring sign)
- varicose : relatively uncommon, with a beaded appearances where dilated bronchi have interspersed sites of relative narrowing
- cystic : severe form with cyst-like bronchi that extend to the pleural surface; air-fluid levels are commonly present
Additionally bronchiectasis can result from the traction of fibrotic lung surrounding an airway. This is known as traction bronchiectasis
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| Type of Bronchiectasis |
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| Gross patology |
Signs described on CT include:
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| Cystic and Cylindrical bronchiectasis |
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| cystic bronchiectasis |
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| cylindrical bronchiectasis Courtesy of radiopaedia.org |
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