Etiology
- ABPA:
- Asthma:
- Chronic Bronchitis:
- Cystic Fibrosis:
- Distal to Central Airway Obstruction: associated with Bronchial Carcinoid, Bronchial Atresia, or Bronchial Cyst
- BCG:
- Lung Cancer:
Physiology
- Mucoid impaction within proximal segment bronchus
- Proximal bronchial dilatation and distention with thick secretions
- Focal angiitis may also occur in the area
Diagnosis
- Sputum Cult+Sens:
-Aspergillus or other sporulating fungi are often found in the specimens
FOB:
CXR/Chest CT Pattern:
1) V-Shaped, Finger-Shaped, Y-Shaped Density: conforms with bronchial subdivision
-Upper lobe predilection
-Absence of calcification
-Air-fluid level may be present within the dilated bronchus, simulating cavitation
-Atelectasis (which may be extensive) may or may not be present distal to impaction
2) Cluster of Grapes Appearance:
-Upper lobe predilection with absence of calcification
4) Lung Nodule:
-Upper lobe predilection with absence of calcification
Sputum GS/Cult:
-Aspergillus or other sporulating fungi are often found in the specimens
Sputum Cult+Sens:
-Aspergillus or other sporulating fungi are often found in the specimens
Treatment
- Usually Transient (but may persist for weeks-months, even grow in size)
- After resolution, may leave residual cylindrical/saccular dilatation of bronchus
References
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