Bronchial atresia

Case contributed by Pablo Famá
Diagnosis almost certain

Presentation

Covid (+), July 2021. Outpatient treatment. Asthenia, cough with bronchial obstruction. Fever (-), "stabbing" pain located in the base of the left lung 6/10, without radiation. Patient does not know she was infected. TC chest 07/21: multifocal pneumonia in right upper lobe and left lower lobe.

Patient Data

Age: 35 years
Gender: Female
ct

Covid-19 checkup. In left upper lobe, a nodular parahilium soft tissue density image, its accompanied by hyper clarity in relation to hyperinflation of the adjacent pulmonary parenchyma.

ct

Covid-19 checkup. In left upper lobe, a nodular parahilium soft tissue density image, its accompanied by hyper clarity in relation to hyperinflation of the adjacent pulmonary parenchyma.

Acknowledgements:

Special thanks to Eugenia Gasco MD, who shared her case with me.

Case Discussion

History: Covid-19 checkup. No previous studies available.

In left upper lobe, a nodular parahilium soft tissue density image measuring 24 mm, associated with tubular structures is identified and it is not enhanced after the administration of contrast medium. Findings compatible with bronchocele. It is accompanied by hyper clarity in relation to hyperinflation of the adjacent dystal pulmonary parenchyma.

Mixed multifocal pulmonary opacities with condensation mainly peripheral and posterior, some with rounded morphology associated with linear opacities, bronchiolar dilatations and some subpleural atelectasis in both upper lobes, predominantly on the right side and in the left lower lobe.

No suspicious pulmonary nodules are seen.

No pleural effusion. No pneumothorax is seen.

Permeable, normal caliber mediastinal main vessels.

Normal size heart without pericardial effusion.

Permeable trachea and bronchi.

Slices on upper abdomen do not show alterations.

Bone window assessment does not show destructive or traumatic injuries.

 

Diagnostic impression: Bilateral multifocal pneumopathy with tomographic findings frequently reported in viral covid-19 pneumonia with consolidation in at least five lung segments. 

Radiological findings compatible with bronchial atresia of left upper lobe apicoposterior segment. 

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