Bronchial atresia
Bronchial atresia is a developmental anomaly characterised by focal obliteration of the proximal segment of a bronchus.
Pathology
The bronchi distal to the atresia become filled with mucus and may form a mucocoele. The lung distal to the atretic bronchus develops normally but is overinflated due to collateral air drift with air trapping.
Location
It is typically at the segmental or subsegmental level. It can involve any lobe but most commonly occurs at the apico-posterior segment of the left upper lobe 2.
Clinical presentation
Bronchial atresia is usually asymptomatic, as with this case found incidentally on the CT chest of a trauma patient. If symptomatic, it may cause shortness of breath, cough or rarely infection.
Radiographic features
HRCT
- atretic bronchial stump(s) often become mucus plugged and can give a finger in glove appearance
- distal lung parenchyma supplied by the atretic segment can be emphysematous due to air trapping : air entering through pores of Kohn
Differential diagnoses
- congenital lobar emphysema (CLE)
- allergic bronchopulmonary aspergillosis (ABPA) : for finger in glove appearance
