Bronchial atresia

Case contributed by Dr Jan Frank Gerstenmaier

Presentation

This young woman presented with gradually worsening dyspnoea over several years. There was no clear history of childhood infection.

Patient Data

Age: 35 years
Gender: Female
X-ray

Chest radiograph

The heart size and contour are normal.  There is hyperlucency of the left upper and mid zone without hyperexpansion or volume loss. Central branching opacity. No pneumothorax. No consolidation or pleural effusion. The right lung appears normal.

CT

CT

There is a focal area of hypoattenuation involving much of the left upper lobe.  There is reduced vascularity within this hyperlucent segment.  Centrally, there is a bronchocele. No evidence of over expansion of the lobe. A posterior mediastinal mass is incidentally seen, slightly above fluid density and most likely representing a bronchopulmonary foregut duplication cyst.

Nuclear medicine

Qantitative V/Q scan

Quantitative analysis demonstrates photopenia within the superolateral aspect of the left upper lobe on the perfusion study with less pronounced defect on ventilation.
X-ray

Post-operative chest radiograph

Surgical clips projected over the left upper zone and left sided volume loss in keeping with left upper lobectomy.

Case Discussion

Segmental hyperlucency secondary to gas trapping with a central bronchocele are the typical findings of bronchial atresia. 

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Case information

rID: 22965
Case created: 8th May 2013
Last edited: 15th Nov 2017
System: Chest
Inclusion in quiz mode: Included

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