Aspiration bronchiolitis

Case contributed by Dr Bruno Di Muzio

Presentation

Previous history of a floor of mouth SCC treated with partial mandibulectomy and segmental mandibular fibula free flap. Presenting with cough.

Patient Data

Age: 60 years
Gender: Female
CT

CT Chest

Diffuse and prominent bronchial wall thickening and tree-in-bud centrilobular nodules within both lungs lower lobes, which are reduced in volume due to partial collapse. Some of the bronchi are fully obliterated by mucous material. The bronchial tree is unremarkable in the remainder of the lobes. Diffuse centrilobular emphysematous changes again noted within the upper lobes. No suspicious mediastinal lymph nodes. 

Case Discussion

The CT chest demonstrates diffuse basilar bronchiectasis with bronchial wall thickening and mucus plugging, as weel as centrilobular nodules and tree-in-bud pattern. Given the distribution within the lower lobes (gravity dependent) and the history of an extensive head and neck surgery and radiotherapy, these findings are likely to represent changes due to subacute/chronic aspiration. Note that ground-glass and consolidation are not present. 

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Case information

rID: 53464
Case created: 19th May 2017
Last edited: 14th Jun 2017
System: Chest
Tag: rmh
Inclusion in quiz mode: Included

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