Bronchial wall thickening

Bronchial wall thickening is an imaging descriptor used to describe abnormal thickening of bronchial walls and can arise from a vast number of pathological entities. It is one of the causes of peribronchial cuffing.

The presence of bronchial wall thickening usually (but not always) implies inflammation of the airways. On a plain radiograph, it can sometimes be often difficult to differentiate from peribronchovascular thickening. 

Pathology

Etiology

• inflammatory
  • bronchial asthma: some studies suggest this sign on plain film may not be useful in reliably distinguishing an acute asthma exacerbation from normal individuals ^1,6
  • cystic fibrosis: may also have an infective component
  • smoking related lung diseases
    • desquamative interstitial pneumonia
    • respiratory bronchiolitis interstitial lung disease
  • cryptogenic organizing pneumonia
• infective
  • bronchitis which in turn can arise from various forms of infection which include
    • acute bronchitis
    • pulmonary Pseudomonas infection
    • pulmonary Aspergillus infection
      • allergic bronchopulmonary aspergillosis
    • pulmonary mycobacterial infections
      • pulmonary Mycobacterium avium complex infection
    bronchitis
• other
  • forms of pulmonary amyloidosis ²
  • neoplastic conditions
    • superficial endobronchial carcinoma ⁵
    • adenoid cystic carcinoma of the tracheobronchial tree
    • diffuse idiopathic pulmonary neuroendocrine cell hyperplasia ³