Presentation
The patient received follow-up imaging and a bronchoscopy at around half a year after lung transplantation
Patient Data
The blue arrows show the bronchial anastomoses on the right and left side.
On the right side, a surgical clip can be seen just caudal to the right main bronchus and bronchial anastomosis. There is a slight irregularity of the caudal part of the bronchial anastomosis which can be considered normal.
On the left side, the bronchial anastomosis shows luminal protrusions both on the caudal (blue arrow) and cranial walls. Although the luminal protrusion is a bit bigger than in most cases, this can still be considered normal and there was no clinical or radiological sign of stenosis.
Endobronchial view of the bronchial anastomoses;
On the right side, the small irregularity of the wall depicted in the CT-image can be seen as slight yellowish decolorations.
On the left side, the luminal protrusion can be clearly seen, most likely resembling pronounced post-surgical regenerative tissue of the anastomosis.
Case Discussion
The stenosis of a bronchial anastomosis is the most common airway complication after lung transplantation. Its development is most common in the first few months after transplantation, however, it may develop at any time.
In this case, there was no relevant stenosis. If in doubt, a possible narrowing of the anastomosis should be communicated in the report. This gives the referring physicians the option to assess for clinical symptoms of an anastomosis stenosis and conduct a bronchoscopy, if necessary.
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