Presentation
Hemoptysis.
Patient Data
Supine CXR reveals a hyperlucency in the right lower zone. A central oval opacity is seen within the lucent area.
Axial lung window of pulmonary CT angiogram, shows hyperaerated and hypovascular basal segments of the right lower lobe. A mucus filled segment of dilated bronchus (bronchocele) is centrally located in the hyeprlucent lung. Note ground-glass opacities in the left lower lobe that are secondary to alveolar hemorrhage.
Coronal reconstruction CT scan shows hyperinflation in the basal segments of the right lower lobe. A branching opacity is seen in the central portion of the involved segments, that represents dilated mucus-filled bronchi (bronchocele). Note ground-glass opacities in the left lower lobe that are secondary to alveolar hemorrhage that is an unrelated symptom and the cause of performing this imaging study.
Case Discussion
Bronchial atresia is an asymptomatic congenital pulmonary disease that is usually found incidentally when the patient is evaluated for any other reason (as in this case, that the disease is diagnosed when the patient was being evaluated for hemoptysis). The classical imaging finding is a segment of hyperlucent lung with a round, oval or branching opacity that is centrally located and represents the dilated mucus filled bronchus distal to the atretic segment (bronchocele). The most common location is left upper lobe, followed by right upper lobe and right middle lobe.
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