Chest radiograph shows a well circumscribed tubular mass in the left upper lobe with distal localized emphysema in a 41-year-old asymptomatic patient.
Coronal-reformatted CT image demonstrate the mass to be a dilated segment of left upper lobe bronchus filled with mucus. Localized emphysema in the left upper lobe is confirmed.
Facts: Bronchial Atresia
- Absence of communication between a segment or subsegmental bronchus and the central airways.
- Most cases are found incidentally on imaging (asymptomatic)
- Most common location = apical posterior segment of the left upper lobe.
Imaging Features
- Mucus plug surrounded by hyperlucent lung.
- Absence of enhancement (enhanced CT and/or endoscopic examination may be required to exclude an endoluminal obstructing lesion)
- Absence of communication with pulmonary vessels
Differential Diagnosis
- Mucous plug distal to bronchial obstruction (endobronchial neoplasm, for example)
- Focal bronchiectasis with mucus plugging
- Pulmonary sequestration
- Allergic bronchopulmonary aspergillosis
- Vascular malformation
Reference:
Parker MS, Rosado de Christenson ML, Abbott GF. Teaching Atlas of Chest Imaging, 2005.
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