FlashPath - Lung - Bronchial Atresia
Transcript of FlashPath - Lung - Bronchial Atresia
FLASHPATHH A Z E M A L I
BRONCHIAL ATRESIA
H A Z E M A L I
CLINICAL• Portion of bronchial tree that have NO connection to the main bronchial
tree, but with normal subsequent generations of bronchi– Usually affect a segmental bronchus (but can also affect lober or subsegmental
bronchui)– Apico-posterior segment of left upper lobe is the most common affected segment
• Usually presents incidentally in asymptomatic young male adults– Some cases presents with recurrent pneumonias, dyspnea and cough– Although it is a congenital disorder, it is rarely diagnosed in children
• The radiology is diagnostic– An ovoid hilar opacity with branches radiating out into a distal area of
hyperinflation
GROSS• Atretic bronchus:
– Usually segmental bronchus– Mucocele “bronchocele” distal to site of obstruction
• Cystic mass• Blind-ended• Mucus-filled
– The atretic bronchus is isolated from the proximal bronchial tree– The subsequent branching pattern distally to it is usually normal
• Distal lung parenchyma is hyperinflated– Because of the “collateral ventilation” in one-way direction– via pores of Kohn, the bronchoalveolar channels of Lambert or via
interbronchiolar channels
GROSSSubtypes:• Isolated• Associated with abnormal systemic arterial connection
(intralobar sequestration)• Associated with abnormal communication to GI tract
(bronchopulmonary foregut malformation)
MICROSCOPY• Mucocele “Bronchocele”
• Dilated large airway• Just distal to the atretic segment• Filled with mucus and mucin-filled macrophages
• Distal lung parenchyma– Alveolar overdistention– Contain abundant mucus
• Features of infection / fibrosis
DIFFERENTIAL DIAGNOSIS“ O t h e r c o n g e n i t a l / c y s t i c l u n g d i s e a s e s ”• Congenital:
– Bronchogenic cyst– Pulmonary sequestration– Congenital pulmonary cysts– Congenital pulmonary airway malformation– Congenital lobar emphysema
• Acquired:– Emphysema– Healed abscess– Honeycombing
• Mixed:– Cystic fibrosis
Affect the whole lobe(not focal)
• Not connected to distal bronchi
• Not cause hyperinflation of distal lung
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